Provider Demographics
NPI:1346849817
Name:COLLINS, ABBIE LEIGH (PNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:ABBIE
Middle Name:LEIGH
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4499 MEDICAL DR STE 289
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3712
Mailing Address - Country:US
Mailing Address - Phone:210-614-3264
Mailing Address - Fax:210-615-0888
Practice Address - Street 1:4499 MEDICAL DR STE 289
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3712
Practice Address - Country:US
Practice Address - Phone:210-614-3264
Practice Address - Fax:210-615-0888
Is Sole Proprietor?:No
Enumeration Date:2020-10-25
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1017177363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics