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NPI Code Detail

MEDICARE: LEIGHANNA M COLLINS

MEDICARE: LEIGHANNA M COLLINS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1689920696
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEIGHANNA M COLLINS
Provider Business Mailing Address
First Line : 2707 BROWNS LN
Second Line :
City : JONESBORO
State : AR
Zip : 72401-7213
Country : US
Telephone Number : 870-972-4939
Fax Number : 870-972-4911
Provider Business Practice Location Address
First Line : 209 S LOCKARD ST
Second Line :
City : BLYTHEVILLE
State : AR
Zip : 72315-2541
Country : US
Telephone Number : 870-763-2139
Fax Number : 870-763-5056
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2012
Last Update Date : 08/29/2018

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