Healthcare Provider Details

I. General information

NPI: 1982970679
Provider Name (Legal Business Name): BRITTANY LEIGH COLLINS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2012
Last Update Date: 09/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8927 HELMICK PL NE
ALBUQUERQUE NM
87122-4228
US

IV. Provider business mailing address

8927 HELMICK PL NE
ALBUQUERQUE NM
87122-4228
US

V. Phone/Fax

Practice location:
  • Phone: 303-669-6414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA-1968-16
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: