MEDICARE: MS. DEBRA L COLLINS M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)		KS

General Provider Information

NPI Number	:	1457341471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA L COLLINS M.S.

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	4023 WESCOE PAVILION
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-6022
Fax Number	:	913-588-4060

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	4023 WESCOE PAVILION
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-6022
Fax Number	:	913-588-4060

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/08/2007

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