Healthcare Provider Details

I. General information

NPI: 1598729709
Provider Name (Legal Business Name): PEGGY S COLLINS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 351
FORT GAY WV
25514-0351
US

IV. Provider business mailing address

PO BOX 351
FORT GAY WV
25514-0351
US

V. Phone/Fax

Practice location:
  • Phone: 803-691-0685
  • Fax:
Mailing address:
  • Phone:
  • Fax: 844-374-0233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number965
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3015599
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: