Individual
CHARLOTTE MCCOLLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN,LPN
Contact information
Practice address
635 TUNDRA DR, HARKER HEIGHTS, TX 76548-2586
(904) 565-6035
Mailing address
635 TUNDRA DR, HARKER HEIGHTS, TX 76548-2586
(904) 565-6035
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
5195601
FL
164X00000X
Licensed Vocational Nurse
Primary
337622
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
337622
TEXAS BOARD OF NURSING
TX
01
—
5195601
STATE OF FL DEPT. OF HEALTH
FL
Enumeration date
12/18/2018
Last updated
12/18/2018
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