Provider Demographics
NPI:1336475557
Name:COLLINS, JAMIE LEIGH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LEIGH
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:LEIGH
Other - Last Name:SCHOONOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1513 HARRISON AVE
Mailing Address - Street 2:SUITE 18
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3356
Mailing Address - Country:US
Mailing Address - Phone:304-637-0180
Mailing Address - Fax:304-637-1004
Practice Address - Street 1:3 HEALTHCARE DR
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-9405
Practice Address - Country:US
Practice Address - Phone:304-457-0063
Practice Address - Fax:304-457-4011
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV479363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWV 479OtherWEST VIRGINIA LICENSE