Provider Demographics
NPI:1609088020
Name:COLLINS, KIMBERLY PAIGE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:PAIGE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3775 HACKS CROSS RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-2302
Mailing Address - Country:US
Mailing Address - Phone:901-214-0053
Mailing Address - Fax:
Practice Address - Street 1:3775 HACKS CROSS RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-2302
Practice Address - Country:US
Practice Address - Phone:901-214-0053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist