Provider Demographics
NPI:1407547169
Name:COLLINS, DAWN V
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:V
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 AIRLINE DR STE 300-170
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2946
Mailing Address - Country:US
Mailing Address - Phone:318-458-8171
Mailing Address - Fax:
Practice Address - Street 1:2430 VANCEVILLE ROAD
Practice Address - Street 2:N/A
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-6314
Practice Address - Country:US
Practice Address - Phone:318-458-8171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula