Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD066480L | PA |
Y | 208600000X | Surgeon | MD066480L | PA |
N | 2086S0120X | Pediatric Surgery | 0101261340 | VA |
N | 2086S0120X | Pediatric Surgery | MD066480L | PA |
NPI | 1255428819 |
---|---|
Provider Name | Dr. Joy Lynn Collins |
First Address | Roanoke, VA 24013-2232 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 15/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101032781 | (05) | PA |
I10174 | (02) | PA |