Healthcare Provider Details

I. General information

NPI: 1841146230
Provider Name (Legal Business Name): MACI BLAIN COLLINS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N CATE ST
HAMMOND LA
70401-3357
US

IV. Provider business mailing address

23380 NOBLE OAK DR
SPRINGFIELD LA
70462-6005
US

V. Phone/Fax

Practice location:
  • Phone: 985-662-0887
  • Fax: 985-348-0757
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number205361
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: