Individual
DANIELLE MELISSA KOLLASCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPAS, PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2276
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
360101060757896
CPHT
—
Enumeration date
08/05/2014
Last updated
09/24/2018
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