Provider Demographics
NPI:1134810864
Name:COLLINS, ALICE MARGARET (PA-C)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:MARGARET
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3651 COLLEGE BLVD STE 100B
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1910
Mailing Address - Country:US
Mailing Address - Phone:913-362-0031
Mailing Address - Fax:913-253-1766
Practice Address - Street 1:3651 COLLEGE BLVD STE 100B
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1910
Practice Address - Country:US
Practice Address - Phone:913-362-0031
Practice Address - Fax:913-253-1766
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS15-02805363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical