IndividualActive
Samantha Mccollough, CRNP
NPI 1174042501 · Family Nurse Practitioner · Jack, AL
Provider details
- NPI number
- 1174042501
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNP
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1-143531 (AL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1020 County Road 114
Jack, AL 36346-6228
Phone: (334) 830-4624
Fax: (833) 320-2199
Approximate (ZIP-level) locationGet directions
Mailing address
1020 County Road 114
Jack, AL 36346-6228
Registry dates
- Enumerated
- 2017-09-18
- Last updated
- 2025-04-10
- Certified
- 2025-04-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.