1033271077 NPI number — MS. KATHRYN MARY COLLINS MS, RN, CNP, CNS

Table of content: MS. KATHRYN MARY COLLINS MS, RN, CNP, CNS (NPI 1033271077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033271077 NPI number — MS. KATHRYN MARY COLLINS MS, RN, CNP, CNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLLINS
Provider First Name:
KATHRYN
Provider Middle Name:
MARY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, RN, CNP, CNS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BURNES
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNP, CNS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033271077
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3900 55TH ST. NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-252-0885
Provider Business Mailing Address Fax Number:
507-529-8452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3900 55TH ST. NW
Provider Second Line Business Practice Location Address:
VA CLINIC
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-252-0885
Provider Business Practice Location Address Fax Number:
507-529-8452
Provider Enumeration Date:
12/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364SP0809X , with the licence number:  R111724 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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