Provider Demographics
NPI:1982761409
Name:COLLINS, LYNN COBB
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:COBB
Last Name:COLLINS
Suffix:
Gender:M
Credentials:
Other - Prefix:MRS
Other - First Name:LYNN
Other - Middle Name:COBB
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM
Mailing Address - Street 1:36000 DARNALL LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-5095
Mailing Address - Country:US
Mailing Address - Phone:254-288-8115
Mailing Address - Fax:254-286-7327
Practice Address - Street 1:36000 DARNALL LOOP
Practice Address - Street 2:
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-288-8115
Practice Address - Fax:254-286-7237
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK39049176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife