Healthcare Provider Details

I. General information

NPI: 1932888682
Provider Name (Legal Business Name): JOANNA COLLINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7738 A C SKINNER PKWY APT 6403
JACKSONVILLE FL
32256-8160
US

IV. Provider business mailing address

7738 A C SKINNER PKWY APT 6403
JACKSONVILLE FL
32256-8160
US

V. Phone/Fax

Practice location:
  • Phone: 904-386-1581
  • Fax:
Mailing address:
  • Phone: 904-386-1581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: