Provider Demographics
NPI:1851411524
Name:COLLINS, KAARON (R N)
Entity Type:Individual
Prefix:MRS
First Name:KAARON
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-3509
Mailing Address - Country:US
Mailing Address - Phone:843-394-3884
Mailing Address - Fax:
Practice Address - Street 1:409 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-3509
Practice Address - Country:US
Practice Address - Phone:843-394-3884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC376241Medicaid
SC376241Medicaid