Provider Demographics
NPI:1477647493
Name:COLLINS, KAREN H (FNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:H
Last Name:COLLINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:HUIETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 RICHLAND MEDICAL PARK DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6849
Mailing Address - Country:US
Mailing Address - Phone:803-434-2383
Mailing Address - Fax:803-434-8326
Practice Address - Street 1:3 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:SUITE 310
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6849
Practice Address - Country:US
Practice Address - Phone:803-434-2383
Practice Address - Fax:803-434-8326
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3026OtherSC- APRN-FNP
SCRN41778OtherRN LICENSE
SCNP1038Medicaid
SCAA15778946Medicare PIN
SCRN41778OtherRN LICENSE