Healthcare Provider Details

I. General information

NPI: 1598776700
Provider Name (Legal Business Name): BARBARA K COLLIER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BARBARA MICKEL

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1137 S DUPREE AVE
BROWNSVILLE TN
38012-3255
US

IV. Provider business mailing address

PO BOX 1258
WAYNESBORO TN
38485-1258
US

V. Phone/Fax

Practice location:
  • Phone: 731-779-0902
  • Fax:
Mailing address:
  • Phone: 931-253-1110
  • Fax: 256-664-4280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20256
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: