Provider Demographics
NPI:1265893838
Name:COLLINS, PAMELA (RN BSN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1571
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-1571
Mailing Address - Country:US
Mailing Address - Phone:708-646-1934
Mailing Address - Fax:770-485-2780
Practice Address - Street 1:488 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-2386
Practice Address - Country:US
Practice Address - Phone:708-646-1934
Practice Address - Fax:770-485-2780
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health