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NPI Code Detail

MEDICARE: MR. MARK COLLIER FNP

MEDICARE: MR. MARK COLLIER FNP
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 Practitioner89346-3582LA

Other Identifiers

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

General Provider Information

NPI Number : 1861499972
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK COLLIER FNP
Provider Business Mailing Address
First Line : 1205 SAINT CHARLES AVE
Second Line : SUITE 1304
City : NEW ORLEANS
State : LA
Zip : 70130-4356
Country : US
Telephone Number : 985-778-8293
Fax Number : 504-398-1030
Provider Business Practice Location Address
First Line : 8200 HIGHWAY 23
Second Line :
City : BELLE CHASSE
State : LA
Zip : 70037-2607
Country : US
Telephone Number : 504-398-1100
Fax Number : 504-398-1030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 10/21/2007

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