Provider Demographics
NPI: | 1780615039 |
---|---|
Name: | COLLINS, MARGARET K (CRNA) |
Entity type: | Individual |
Prefix: | |
First Name: | MARGARET |
Middle Name: | K |
Last Name: | COLLINS |
Suffix: | |
Gender: | F |
Credentials: | CRNA |
Other - Prefix: | |
Other - First Name: | MARGARET |
Other - Middle Name: | |
Other - Last Name: | BROOME |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | CRNA |
Mailing Address - Street 1: | 5959 GATEWAY BLVD W |
Mailing Address - Street 2: | STE. 120 |
Mailing Address - City: | EL PASO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 79925-3331 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 915-779-1716 |
Mailing Address - Fax: | 915-771-6558 |
Practice Address - Street 1: | 5959 GATEWAY BLVD W |
Practice Address - Street 2: | STE. 120 |
Practice Address - City: | EL PASO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 79925-3331 |
Practice Address - Country: | US |
Practice Address - Phone: | 915-779-1716 |
Practice Address - Fax: | 915-771-6558 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-05 |
Last Update Date: | 2008-08-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 237847 | 367500000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 84509U | Other | BCBS |
TX | 109890705 | Medicaid | |
TX | 8D5026 | Medicare PIN | |
TX | H2628 | Medicare PIN |