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NPI Code Detail

MEDICARE: STEPHANIE RENEE COLLINS

MEDICARE: STEPHANIE RENEE COLLINS
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
1183500000XPharmacist9086TN

General Provider Information

NPI Number : 1831498617
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE RENEE COLLINS
Provider Business Mailing Address
First Line : 650 HIGHWAY 100
Second Line :
City : CENTERVILLE
State : TN
Zip : 37033-1214
Country : US
Telephone Number : 931-729-5005
Fax Number : 931-729-2339
Provider Business Practice Location Address
First Line : 650 HIGHWAY 100
Second Line :
City : CENTERVILLE
State : TN
Zip : 37033-1214
Country : US
Telephone Number : 931-729-5005
Fax Number : 931-729-2339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2011
Last Update Date : 03/20/2011

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Directions to “ STEPHANIE RENEE COLLINS ” Practice Location

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