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General NPI Number Information
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NPI Number | 1689070021
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Entity Type | Individual
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Provider Name | SHELIA COLLINS
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Gender | Female
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 105 DEER CREEK
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City | ARCOLA
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State | MS
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Zip | 38722-3239
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Country | US
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Telephone | 662-827-0607
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Fax |
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Provider Business Mailing Address
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Address Line | 201 MERCER AVE
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City | HOLLANDALE
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State | MS
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Zip | 38748-3239
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Country | US
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Telephone | 662-827-0607
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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 | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number | 261QA0600X
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License Number State | MS
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