# COLLABORATIVE CARE CONSULTANTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972309987
- **Authorized official:** GRETCHEN MOEN (OWNER)
- **Authorized official phone:** (651) 485-3923

## Contact information

- **Practice address:** 1057 GRAND AVE FL 2, SAINT PAUL, MN 55105-3002
- **Practice address phone:** (651) 384-1736
- **Practice address fax:** (651) 666-1507
- **Mailing address:** 4734 WESTMINSTER CIR, EAGAN, MN 55122-2756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/20/2025
- **Last updated:** 07/18/2025