Individual
KATHLEEN A COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1700 TUTTLE ST, BARABOO, WI 53913-3319
(608) 355-3800
Mailing address
1700 TUTTLE ST, BARABOO, WI 53913-3319
(608) 355-3800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1155-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508822404
—
WI
Enumeration date
04/21/2006
Last updated
11/05/2020
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