Mittie Charolett Collins
Individual provider Active NPI Driver · Cabot, AR
NPI 1073174348 · NPPES record last updated Jun 26, 2019
Key facts
- NPI
- 1073174348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 2792 S 2ND St Ste B
Cabot, AR 72023-7064 - Phone
- (870) 932-3600
- NPI assigned
- Jun 26, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Unlimited Learning Academy of Cabot | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
2792 S 2ND St Ste B
Cabot, AR 72023-7064
Mailing address
1900 Stillwater Dr
Jonesboro, AR 72404-9119
Phone (870) 932-3600
Other providers in Cabot, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.