Healthcare Provider Details

I. General information

NPI: 1679182935
Provider Name (Legal Business Name): BILLIE MARIE COLLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2020
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4329 HUGHES BRANCH RD
HUNTINGTON WV
25701-9768
US

IV. Provider business mailing address

430 EMORY CENTERPOINT RD
OAK HILL OH
45656-9068
US

V. Phone/Fax

Practice location:
  • Phone: 304-733-6415
  • Fax: 304-733-6429
Mailing address:
  • Phone: 740-395-6185
  • Fax: 304-733-6429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number58841
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: