Individual
SHANTA MITCHELL COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
955 REDAN TRCE, STONE MOUNTAIN, GA 30088-2562
(678) 320-8349
Mailing address
PO BOX 2321, STONE MOUNTAIN, GA 30086-2321
(678) 320-8349
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN246802
GA
Other
Enumeration date
12/01/2019
Last updated
12/01/2019
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