Healthcare Provider Details

I. General information

NPI: 1043165525
Provider Name (Legal Business Name): CSILLA COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1099 INDIAN MOUND DR STE A
MT STERLING KY
40353-1652
US

IV. Provider business mailing address

1099 INDIAN MOUND DR STE A
MT STERLING KY
40353-1652
US

V. Phone/Fax

Practice location:
  • Phone: 859-517-4633
  • Fax: 859-203-0843
Mailing address:
  • Phone: 859-517-4633
  • Fax: 859-203-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: