Provider Demographics
NPI:1255011912
Name:MCCOLLINS, CA'NAJAH D'NAY
Entity type:Individual
Prefix:
First Name:CA'NAJAH
Middle Name:D'NAY
Last Name:MCCOLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CA'NAJAH
Other - Middle Name:D'NAY
Other - Last Name:ALFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:428 HIGHWAY 6 E STE 283
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-3000
Mailing Address - Country:US
Mailing Address - Phone:662-473-7817
Mailing Address - Fax:
Practice Address - Street 1:169 HIGHWAY 6 E STE 214
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-9415
Practice Address - Country:US
Practice Address - Phone:662-473-7817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS5907932471C3402X
MS2579542471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography