MEDICARE: CARLA D. COLLINS FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN176277	GA
2	163W00000X	Registered Nurse	RN176277	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386882603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA D. COLLINS FNP

Provider Business Mailing Address
First Line	:	PO BOX 38
Second Line	:
City	:	REIDSVILLE
State	:	GA
Zip	:	30453-0038
Country	:	US
Telephone Number	:	912-542-3050
Fax Number	:	912-542-3051

Provider Business Practice Location Address
First Line	:	200A S MAIN ST
Second Line	:
City	:	REIDSVILLE
State	:	GA
Zip	:	30453-4602
Country	:	US
Telephone Number	:	912-542-3050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2009
Last Update Date	:	01/22/2026

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