Mary Jeanette Collins, ATC, LATC
Individual provider Active NPI Athletic Trainer · Fayette, MO
NPI 1124396288 · NPPES record last updated Dec 5, 2011
Key facts
- NPI
- 1124396288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 2010019646 (MO)
- Practice address
- 411 Central Methodist SQ
Fayette, MO 65248-1104 - Phone
- (660) 248-6289
- NPI assigned
- Dec 5, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010019646 | MO | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2010019646 | MO | Yes |
Addresses
Primary practice location
411 Central Methodist SQ
Fayette, MO 65248-1104
Mailing address
614 S Main St
Brookfield, MO 64628-2341
Phone (660) 734-2083
Other providers in Fayette, MO
- Central Methodist University
- Central Methodist University
- Central Methodist University Sports Medicine/Athletic Training
- Sam Cheng
- Mary Ann T Coatney
- Complete Health Care Solutions, Inc
- Complete Health Care Solutions, Inc
- Complete Health Care Solutions, Inc.
- Tony D Cook
- Cooper County Memorial Hospital
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2011. 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.