Collado, Jerry C

Collado, Jerry C is an individual health care provider with primary practice located at 6919 Old Canton Rd , Ridgeland MS 39157-1268. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Collado, Jerry C can be contacted via phone (601) 956-0911.

Contact Information

Primary practice address
6919 Old Canton Rd Ridgeland MS 39157-1268
Phone: (601) 956-0911
Fax: (601) 957-8439
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R862534 Mississippi

Profile Details

NPI number 1407081862
LBN Legal business name Collado, Jerry C
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2009
Last updated Aug 27th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407081862 NPPES
Mississippi Other 302I502230 MEDICARE PTAN

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