Collins, Stacey Lynn
Collins, Stacey Lynn is an individual health care provider with primary practice located at 119 Boone Ridge Dr Suite 201, Johnson City TN 37615-4998. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Collins, Stacey Lynn can be contacted via phone (423) 282-1480.Contact Information
Primary practice address
119 Boone Ridge Dr Suite 201
Johnson City TN 37615-4998
Phone: (423) 282-1480
Fax: (423) 928-1353
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 11024 | Tennessee |
Profile Details
| NPI number | 1871563981 |
|---|---|
| LBN Legal business name | Collins, Stacey Lynn |
| Credentials | Advanced Practice Nurse (APN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | Aug 28th, 2013 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871563981 | NPPES |
| Tennessee | MEDICAID | 3640259 | |
| Tennessee | Other | TN0109 |
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