Basic Information
| Provider Information | |||||||||
| NPI: | 1700821030 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COLLINS | ||||||||
| FirstName: | JANICE | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11090 GLENHURST PASS | ||||||||
| Address2: | |||||||||
| City: | JOHNS CREEK | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300975790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6783714699 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11975 MORRIS RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ALPHARETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300054419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705212295 | ||||||||
| FaxNumber: | 7702550333 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 05/06/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | RN117850 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.