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General NPI Number Information
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NPI Number | 1821617556
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Entity Type | Individual
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Provider Name | JOSANA ELIZABETH COLLINS PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 5849 CRESCENT LN
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City | COLLEYVILLE
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State | TX
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Zip | 76034-7630
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Country | US
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Telephone | 909-226-1722
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Fax |
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Provider Business Mailing Address
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Address Line | 5849 CRESCENT LN
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City | COLLEYVILLE
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State | TX
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Zip | 76034-7630
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Country | US
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Telephone | 909-226-1722
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA13369
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License Number State | TX
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