Individual
HEATHER J COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1600 ST. JOHNS BLVD, STE 101, MAPLEWOOD, MN 55109-1190
(651) 842-5355
(651) 770-9153
Mailing address
PO BOX 43, MR 10202, MINNEAPOLIS, MN 55440-0043
(612) 262-1166
(612) 262-4258
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9587
MN
363AS0400X
Surgical Physician Assistant
9587
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101656300
—
MN
Enumeration date
03/14/2006
Last updated
11/04/2020
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