Provider Demographics
NPI:1639543242
Name:COLLINS, LINDSAY
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
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 1:904 WOLLARD BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MO
Mailing Address - Zip Code:64085-2229
Mailing Address - Country:US
Mailing Address - Phone:816-470-5432
Mailing Address - Fax:816-470-7305
Practice Address - Street 1:904 WOLLARD BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MO
Practice Address - Zip Code:64085-2229
Practice Address - Country:US
Practice Address - Phone:816-470-5432
Practice Address - Fax:816-470-7305
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015030925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist