MS. THEA S COLLIN (NPI# 1639255078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639255078 |
| Entity Type | Individual |
| Full Name | MS. THEA S COLLIN |
| Credential | MS,PNP,CS |
| Practice Address |
907 Bell St Conway SC 29526-4113 |
| Mailing Address |
5105 Columbia St Conway SC 29526-8607 |
| Practice Telephone | 8432482727 |
| Practice Fax Number | 8432485107 |
| Enumeration Date | 2006-10-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
APN780 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| X | 364SP0807X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Child & Adolescent |
APN780 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | LICENSE NO | APN780 | 01 |
| Street Address |
907 BELL ST |
| City | CONWAY |
| State | SC |
| Zip Code | 29526-4113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518986637 | Conway Pediatrics,pa | Legal Medicine | 907 Bell St, Conway, SC 29526-4113 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
| 1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
| 1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
| 1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
| 1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| Find all providers in zip 29526 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558835355 | Conway Hospital Inc | Nurse Practitioner | 124 Professional Park Drive, Ste A, Conway, SC 29526-9260 | 2019-01-15 |
| 1104220433 | Diana L Taylor | Nurse Practitioner | 140 Professional Park Drive, Conway, SC 29526 | 2014-10-15 |
| 1740713650 | Linda Christine Post | Nurse Practitioner | 2505 College Ave, Conway, AR 72034 | 2017-04-07 |
| 1144637166 | Amanda Gerrald | Nurse Practitioner | 1608 Main St, Conway, SC 29526-3572 | 2014-07-22 |
| 1457678054 | Jo E. Greenhill | Nurse Practitioner | 1500 Museum Rd, Conway, AR 72032 | 2010-04-23 |
| 1609106392 | Shalini Gates | Nurse Practitioner | 1608 Main St, Conway, SC 29526-3572 | 2010-01-03 |
| 1578898748 | Betsy Anna Efird | Nurse Practitioner | 2710 College Ave, Conway, AR 72034-6141 | 2009-10-06 |
| 1366775553 | Karen Louise Martin | Nurse Practitioner | 2710 College Ave, Conway, AR 72034-6141 | 2009-09-07 |
| 1588800890 | Amanda J Bruce | Nurse Practitioner | 124 Professional Park Dr, Ste A, Conway, SC 29526-9260 | 2008-12-17 |
| 1356419972 | Sharyn Mae Flanagan-rogers | Nurse Practitioner | 298 White Mountain Hwy, Conway, NH 03818-4204 | 2006-12-01 |
| Find all providers in CONWAY | ||||
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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.