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:
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Health care specialties

SpecialtyCodeLicense #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 11 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 1871563981 NPPES
Tennessee MEDICAID 3640259
Tennessee Other TN0109

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