MEDICARE: MRS. JESSICA SUE COLLINS APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.020778	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649704081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA SUE COLLINS APRN

Provider Business Mailing Address
First Line	:	PO BOX 188
Second Line	:
City	:	CHILLICOTHEE
State	:	OH
Zip	:	45601-0188
Country	:	US
Telephone Number	:	740-773-4366
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 BURLINGTON RD STE 240
Second Line	:
City	:	JACKSON
State	:	OH
Zip	:	45640-9360
Country	:	US
Telephone Number	:	740-286-5075
Fax Number	:	740-395-8411

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

Provider Enumeration Date	:	04/12/2017
Last Update Date	:	05/27/2026

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