JACLYN RAE COLLIE (NPI# 1922509520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922509520 |
| Entity Type | Individual |
| Full Name | JACLYN RAE COLLIE |
| Credential | CRNP |
| Practice Address |
902 W Washington St Athens AL 35611-2438 |
| Mailing Address |
111 Sarah Jane Dr Madison AL 35757-7739 |
| Practice Telephone | 2562169777 |
| Practice Fax Number | 2562169776 |
| Mailing Telephone | 3147490001 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2019-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-153844 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 111 Sarah Jane Dr, Madison, AL 357577739 | 3147490001 |
| Street Address |
902 W WASHINGTON ST |
| City | ATHENS |
| State | AL |
| Zip Code | 35611-2438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538146055 | Randall L Dearment | General Practice | 902 W Washington St, Athens, AL 35611-2438 | 2005-12-27 |
| 1104353226 | Waddell Center Family Medicine | Family Medicine | 902 W Washington St, Athens, AL 35611-2438 | 2017-05-19 |
| 1720449796 | Lindsey T Smith | Nurse Practitioner | 902 W Washington St, Athens, AL 35611-2438 | 2016-03-17 |
| 1215298849 | Melissa C Gray | Family Medicine | 902 W Washington St, Athens, AL 35611-2438 | 2012-05-30 |
| 1326297987 | Christopher George Enoe | Family Medicine | 902 W Washington St, Athens, AL 35611-2438 | 2008-09-18 |
| 1073769493 | Binod Bista | Family Medicine | 902 W Washington St, Athens, AL 35611-2438 | 2008-08-18 |
| 1003006289 | Waddell Center Family Medicine | Family Medicine | 902 W Washington St, Athens, AL 35611-2438 | 2007-07-25 |
| 1548206659 | James Russell Walker | Internal Medicine | 902 W Washington St, Athens, AL 35611-2438 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023529 | Aderholt Medical, LLC | Family Medicine | 320 Old Us-31 N, Athens, AL 35611 | 2020-11-03 |
| 1295333409 | Olivia Palmer | Nurse Practitioner | 770 W Market St, Athens, AL 35611 | 2020-10-12 |
| 1104467901 | Michael S Layman | Hearing Instrument Specialist | 809 Hwy 72 W., Steg, Suite G, Athens, AL 35611 | 2019-10-02 |
| 1508425901 | Courtney Rae Ringrose | Dentist | 1323 Us Highway 72 E, Athens, AL 35611 | 2019-06-10 |
| 1225585391 | Advantage Health Solutions,llc | Family Medicine | 707 West Market St Ste A, Athens, AL 35611 | 2016-09-07 |
| 1306293618 | Brady Aderholt | Nurse Practitioner | 411 N Houston St, Athens, AL 35611 | 2016-05-17 |
| 1891154647 | Hh Health System - Retail Pharmacy LLC | Pharmacy | 700 W. Market Street, Suite 100, Athens, AL 35611 | 2016-02-22 |
| 1790188779 | U Save Pharmacies LLC | Pharmacy | 1285 Hwy 72 E, Athens, AL 35611 | 2014-10-03 |
| 1497176564 | Hometown Pharmacy of Limestone County, LLC | Pharmacy | 100 Highway 31, Suite H, Athens, AL 35611 | 2013-12-17 |
| 1760819015 | William Todd Waggoner | Pharmacist | 104 Highway 31 North, Athens, AL 35611 | 2013-10-02 |
| Find all providers in zip 35611 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333409 | Olivia Palmer | Nurse Practitioner | 770 W Market St, Athens, AL 35611 | 2020-10-12 |
| 1831706449 | Melissa Mason | Nurse Practitioner | 700 Oglethorpe Ave # C7, Athens, GA 30606-2221 | 2020-09-28 |
| 1972117992 | Kei Martin | Nurse Practitioner | 25569 Evergreen Ln, Athens, AL 35613-6162 | 2020-09-08 |
| 1699315192 | Paul Stewart | Nurse Practitioner | 906 Rolling Dr, Athens, TX 75751-2944 | 2020-01-13 |
| 1679118616 | Erica Lyn Prater | Nurse Practitioner | 445 Providence Rd, Athens, GA 30606-1933 | 2019-11-13 |
| 1932758828 | Paula White | Nurse Practitioner | 12 Walcon Ln Apt 2, Athens, TN 37303-3764 | 2019-09-04 |
| 1114574621 | April Lee White | Nurse Practitioner | 3655 Whiteoak Creek Rd, Athens, WV 24712-9628 | 2019-08-20 |
| 1255988937 | Brandi Jones | Nurse Practitioner | 115 Medical Cir Ste 100, Athens, TX 75751-9004 | 2019-08-19 |
| 1467008128 | Erica Denise Long | Nurse Practitioner | 220 S Jackson St, Athens, TN 37303-4713 | 2019-08-16 |
| 1215598131 | Patricia Ann Torres | Nurse Practitioner | 494 Baxter St, Athens, GA 30605-1172 | 2019-06-21 |
| Find all providers in ATHENS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.