Mary Jeanette Collins, ATC, LATC
Specialist/Technologist, Athletic Trainer in Fayette, MO. Individual provider (NPI-1).
NPI number1124396288
StatusActive
Last updated in NPPESDec 5, 2011
Details
- NPI
- 1124396288
- Entity type
- Individual (NPI-1)
- Name
- Mary Jeanette Collins
- Credential
- ATC, LATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 5, 2011
- Last updated
- Dec 5, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2010019646 | MO | Yes |
Practice location
411 Central Methodist SqFayette, MO 65248-1104
Phone 660-248-6289
Mailing address
614 S Main StBrookfield, MO 64628-2341
Phone 660-734-2083
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All 19 Athletic Trainer providers in Fayette · All 109 providers in Fayette
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