Individual
MISS LATONYA COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN-MSM
Contact information
Practice address
300 EAST HOSPITAL ROAD, FORT GORDON, GA 30905-5650
(706) 787-9123
Mailing address
300 EAST HOSPITAL ROAD, FORT GORDON, GA 30905-5650
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN144043
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN144043
NURSING LICENSE
GA
Enumeration date
01/10/2014
Last updated
01/10/2014
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