Healthcare Provider Details

I. General information

NPI: 1235066606
Provider Name (Legal Business Name): ALYCIA COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3189 KIRBY WHITTEN RD STE 203A
BARTLETT TN
38134-2854
US

IV. Provider business mailing address

3189 KIRBY WHITTEN RD STE 203A
BARTLETT TN
38134-2854
US

V. Phone/Fax

Practice location:
  • Phone: 901-779-7508
  • Fax: 877-497-2554
Mailing address:
  • Phone: 901-779-7508
  • Fax: 877-497-2554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberI000000040389
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: