Healthcare Provider Details

I. General information

NPI: 1427671957
Provider Name (Legal Business Name): BARBARA K COLLIER APSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 MERCER ST
ELIZABETHTOWN KY
42701-2731
US

IV. Provider business mailing address

107 POTOMAC ST
RADCLIFF KY
40160-9042
US

V. Phone/Fax

Practice location:
  • Phone: 270-300-1841
  • Fax: 270-900-0403
Mailing address:
  • Phone: 270-300-1841
  • Fax: 270-900-0403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number1182890
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: