Individual
JACKIE L COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
875 E MAIN ST, WACONIA, MN 55387-1081
(866) 389-2727
Mailing address
6725 YORK AVE S APT 457, EDINA, MN 55435-3232
(952) 221-0950
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R128366-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105787
MEDICA
MN
01
—
1032598
PREFERREDONE
MN
01
—
1241627
AMERICA'S PPO
MN
01
—
151404
UCARE MN
MN
05
—
404934900
—
MD
05
—
41184100
—
WI
01
—
67B81CO
BLUE CROSS BLUE SHIELD MN
MN
05
—
737611100
—
MN
01
—
HP32641
HEALTHPARTNERS
MN
Enumeration date
03/10/2006
Last updated
07/08/2025
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