Provider Demographics
NPI:1932620416
Name:COLLINS, JORDAN BRITTON (PA-C)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:BRITTON
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:A
Other - Last Name:BRITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:142 PELETIER SHORES DR
Mailing Address - Street 2:
Mailing Address - City:PELETIER
Mailing Address - State:NC
Mailing Address - Zip Code:28584-0129
Mailing Address - Country:US
Mailing Address - Phone:304-320-8928
Mailing Address - Fax:
Practice Address - Street 1:4370 ARENDELL ST STE A
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2800
Practice Address - Country:US
Practice Address - Phone:252-222-0204
Practice Address - Fax:252-222-0433
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2812363AM0700X
NC0010-08255363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical