Individual
BRANDIE DAWN COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
520 S EAGLE RD, STE 3102, MERIDIAN, ID 83642-6351
(208) 706-5100
(208) 706-5169
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA188
ID
Other
Enumeration date
05/08/2006
Last updated
01/12/2013
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