Provider Demographics
NPI:1740319052
Name:COLLINS, ABIGAIL BENNETT (LPN)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:BENNETT
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6265 MAMIE DR
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8564
Mailing Address - Country:US
Mailing Address - Phone:614-837-5603
Mailing Address - Fax:614-837-5803
Practice Address - Street 1:6265 MAMIE DR
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8564
Practice Address - Country:US
Practice Address - Phone:614-837-5603
Practice Address - Fax:614-837-5803
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH095179164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse