Most Relevant Information
Provider Data
| NPI Number: | 1003444639 |
| Provider Name: | NICOLE COLLINS |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/30/2020 |
| Last Updated: | 03/30/2020 |
Provider Practice Location
3084 WESTFORK DR STE C
BATON ROUGE
LA
708162254
Practice Location Phone/Fax
| Phone: | 2252966083 |
| Fax: | 2252966082 |
Provider Mailing Location
9403 MANSFIELD RD
SHREVEPORT
LA
711183815
Provider Mailing Phone/Fax
| Phone: | 3188618938 |
| Fax: | 3188623554 |