Stephanie April Collins, APRN
Individual provider Active NPI Nurse Practitioner · Wichita, KS
NPI 1891044376 · NPPES record last updated Apr 28, 2022
Key facts
- NPI
- 1891044376
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 53-75731 (KS)
- Practice address
- 1131 S Clifton Ave
Suite B
Wichita, KS 67218-2955 - Phone
- (316) 462-1040
- Fax
- (316) 462-1042
- NPI assigned
- Aug 30, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120925000496 | KS | Practitioner - Nurse Practitioner | 0345499950 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53-75731 | KS | MD | Nurse Practitioner |
| 53-75731-071 | KS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wesley Physicians Medical Specialties LLC | Current |
Accepting new patients | |
| Kansas Long Term Care Physicians, LLC | Past | Accepting new patients |
Locations
2600 N Woodlawn Blvd
Wichita, KS 67220
Phone (316) 260-1690
8080 E Pawnee St
Wichita, KS 67207
Phone (316) 652-0526
550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 53-75731-071 | KS | |
| Nurse Practitioner | 363L00000X | 53-75731 | KS | Yes |
Addresses
Primary practice location
1131 S Clifton Ave
Suite B
Wichita, KS 67218-2955
Mailing address
1131 S Clifton Ave
Suite B
Wichita, KS 67218-2955
Phone (316) 462-1040
Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.