Provider Demographics
NPI:1033271077
Name:COLLINS, KATHRYN MARY (MS, RN, CNP, CNS)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:MARY
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MS, RN, CNP, CNS
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:MARY
Other - Last Name:BURNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP, CNS
Mailing Address - Street 1:3900 55TH ST. NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901
Mailing Address - Country:US
Mailing Address - Phone:507-252-0885
Mailing Address - Fax:507-529-8452
Practice Address - Street 1:3900 55TH ST. NW
Practice Address - Street 2:VA CLINIC
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901
Practice Address - Country:US
Practice Address - Phone:507-252-0885
Practice Address - Fax:507-529-8452
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR111724364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult