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Individual
KIMEN M COLGAN
Active
Individual
KIMEN M COLGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3531
AZ
363AS0400X
Surgical Physician Assistant
1366
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41929300
—
WI
Enumeration date
04/12/2006
Last updated
09/19/2016
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