Healthcare Provider Details

I. General information

NPI: 1932729316
Provider Name (Legal Business Name): JILL MARIE COLLINS DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2020
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449 N LIMESTONE
LEXINGTON KY
40508-1875
US

IV. Provider business mailing address

449 N LIMESTONE
LEXINGTON KY
40508-1875
US

V. Phone/Fax

Practice location:
  • Phone: 703-475-6050
  • Fax:
Mailing address:
  • Phone: 703-475-6050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number285300
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number4023223
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number285300
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024181582
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOLL-G68QT
License Number StateNC
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4023223
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: