Provider Demographics
NPI:1831987551
Name:COLLINS, BRYNN KATHRYNE
Entity type:Individual
Prefix:
First Name:BRYNN
Middle Name:KATHRYNE
Last Name:COLLINS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 LOST OAK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-1056
Mailing Address - Country:US
Mailing Address - Phone:704-996-9082
Mailing Address - Fax:
Practice Address - Street 1:1217 LOST OAK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-1056
Practice Address - Country:US
Practice Address - Phone:704-996-9082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program