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NPI Code Detail

MEDICARE: MR. JESSE COLLIER APRN FNP-C

MEDICARE:  MR. JESSE  COLLIER  APRN FNP-C
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
1363LF0000XFamily Nurse Practitioner1034171TX

General Provider Information

NPI Number : 1710567540
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JESSE COLLIER APRN FNP-C
Provider Business Mailing Address
First Line : 801 PRAIRIE FALCON GLN
Second Line :
City : WAXAHACHIE
State : TX
Zip : 75167-1269
Country : US
Telephone Number : 702-875-1374
Fax Number :
Provider Business Practice Location Address
First Line : 3116 CAPITAL WAY STE 200
Second Line :
City : FORT WORTH
State : TX
Zip : 76177-4305
Country : US
Telephone Number : 214-302-7885
Fax Number : 978-510-6895
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2021
Last Update Date : 03/16/2026

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Directions to “ MR. JESSE COLLIER APRN FNP-C” Practice Location

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