Provider Demographics
NPI:1386432136
Name:MCCOLLUM, AKIA MARQUISE (CNM, APRN)
Entity type:Individual
Prefix:
First Name:AKIA
Middle Name:MARQUISE
Last Name:MCCOLLUM
Suffix:
Gender:F
Credentials:CNM, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13720 ATLANTIS ST APT 477
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4177
Mailing Address - Country:US
Mailing Address - Phone:843-478-4662
Mailing Address - Fax:
Practice Address - Street 1:4001 FAIR RIDGE DR STE 304
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2917
Practice Address - Country:US
Practice Address - Phone:703-273-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024192549176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife