Basic Information
| Provider Information | |||||||||
| NPI: | 1326794850 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLLIER | ||||||||
| FirstName: | BILLIE | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2192 | ||||||||
| Address2: | |||||||||
| City: | FORREST CITY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723362192 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707352737 | ||||||||
| FaxNumber: | 8705513724 | ||||||||
| Practice Location | |||||||||
| Address1: | 413 W TYLER AVE | ||||||||
| Address2: | |||||||||
| City: | WEST MEMPHIS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723014149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707352737 | ||||||||
| FaxNumber: | 8705513724 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2022 | ||||||||
| LastUpdateDate: | 02/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 02/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 854392 | MS | Y | Nursing Service Providers | Registered Nurse |
No ID Information.