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General NPI Number Information
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NPI Number | 1124463914
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Entity Type | Individual
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Provider Name | AGNES MCKOWEN COLLINS PA
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Gender | Female
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 11/19/2019
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Provider Practice Location Address
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Address Line | 5326 OAK ST.
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City | ST. FRANCISVILLE
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State | LA
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Zip | 70775
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Country | US
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Telephone | 225-635-5848
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Fax | 225-635-5847
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Provider Business Mailing Address
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Address Line | P.O. BOX 487
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City | ST. FRANCISVILLE
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State | LA
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Zip | 70775
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Country | US
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Telephone | 225-635-5848
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Fax | 225-635-5847
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 881
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 320653
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License Number State | LA
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