Provider Demographics
NPI:1689219552
Name:COLLINS, KATIE RHEA (PA-C)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:RHEA
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 DENSO DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-7835
Mailing Address - Country:US
Mailing Address - Phone:423-745-0303
Mailing Address - Fax:423-745-0306
Practice Address - Street 1:2400 DENSO DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-7835
Practice Address - Country:US
Practice Address - Phone:423-745-0303
Practice Address - Fax:423-745-0306
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA3990363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant