Collins, Jackie L

Collins, Jackie L is an individual health care provider with primary practice located at 2805 Campus Dr Ste 105 , Plymouth MN 55441-2677. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Collins, Jackie L can be contacted via phone (763) 519-7440.

Contact Information

Primary practice address
2805 Campus Dr Ste 105 Plymouth MN 55441-2677
Phone: (763) 519-7440
Fax: (763) 519-7445
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R128366-4 Minnesota

Profile Details

NPI number 1023086568
LBN Legal business name Collins, Jackie L
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2006
Last updated Jun 18th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023086568 NPPES
Minnesota Other 1032598 PREFERREDONE
Minnesota Other 151404 PREFERREDONE
Minnesota MEDICAID 737611100 PREFERREDONE
Minnesota MEDICAID 404934900 PREFERREDONE
Minnesota MEDICAID 41184100 PREFERREDONE
Minnesota Other 0105787 PREFERREDONE
Minnesota Other 67B81CO PREFERREDONE
Minnesota Other HP32641 PREFERREDONE
Minnesota Other 1241627 PREFERREDONE

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