Provider Demographics
NPI:1932888682
Name:COLLINS, JOANNA (RN)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7738 A C SKINNER PKWY APT 6403
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8160
Mailing Address - Country:US
Mailing Address - Phone:904-386-1581
Mailing Address - Fax:
Practice Address - Street 1:7738 A C SKINNER PKWY APT 6403
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-8160
Practice Address - Country:US
Practice Address - Phone:904-386-1581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care