Individual
ANGELA COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-5652
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1088847
KY
363L00000X
Nurse Practitioner
Primary
3003955
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2453803
—
OH
05
—
78010584
—
KY
Enumeration date
04/20/2006
Last updated
03/21/2024
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