Provider Demographics
NPI:1922772466
Name:TEYIM, COLLINS MBUH
Entity Type:Individual
Prefix:
First Name:COLLINS
Middle Name:MBUH
Last Name:TEYIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 HUNTERS RD APT H
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-5227
Mailing Address - Country:US
Mailing Address - Phone:240-423-0298
Mailing Address - Fax:
Practice Address - Street 1:1390 HUNTERS RD APT H
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-5227
Practice Address - Country:US
Practice Address - Phone:240-423-0298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCNA20212069376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide