Provider Demographics
NPI:1285103689
Name:COLLINS, JESSICA A (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:COLLINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:A
Other - Last Name:BARRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2220 SE OCEAN BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3301
Mailing Address - Country:US
Mailing Address - Phone:772-220-3339
Mailing Address - Fax:772-286-2635
Practice Address - Street 1:2220 SE OCEAN BLVD STE 301
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3301
Practice Address - Country:US
Practice Address - Phone:772-220-3339
Practice Address - Fax:772-286-2635
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25154207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology