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General NPI Number Information
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NPI Number | 1437382595
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Entity Type | Individual
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Provider Name | LISA CAROL COLLINS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2009
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 2801 S STAUNTON RD
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City | HUNTINGTON
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State | WV
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Zip | 25702-1222
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Country | US
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Telephone | 304-526-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 244 TOWNSHIP ROAD 1287
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City | CHESAPEAKE
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State | OH
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Zip | 45619-8128
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Country | US
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Telephone | 304-528-4600
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 58606
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License Number State | WV
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