Provider Demographics
NPI:1124132865
Name:ALLIANCE OF RN FIRST ASSISTANTS
Entity type:Organization
Organization Name:ALLIANCE OF RN FIRST ASSISTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN FIRST ASSISTANT IN SURGERY
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:314-603-0407
Mailing Address - Street 1:401 HEATHSTONE LANE
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122
Mailing Address - Country:US
Mailing Address - Phone:636-230-3631
Mailing Address - Fax:636-405-2656
Practice Address - Street 1:401 HEATHSTONE LANE
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122
Practice Address - Country:US
Practice Address - Phone:636-230-3631
Practice Address - Fax:636-405-2656
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLIANCE OF RN FIRST ASSISTANTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-19
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO126540163WR0006X
MO098426163WR0006X
MO106743163WR0006X
MO066589163WR0006X
MO083239163WR0006X
MO082595163WR0006X
MO074540163WR0006X
163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty