Provider Demographics
NPI:1386216927
Name:MARANGA, COLLINS (RN)
Entity Type:Individual
Prefix:
First Name:COLLINS
Middle Name:
Last Name:MARANGA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25946 12TH ST W
Mailing Address - Street 2:
Mailing Address - City:ZIMMERMAN
Mailing Address - State:MN
Mailing Address - Zip Code:55398-8584
Mailing Address - Country:US
Mailing Address - Phone:763-232-3555
Mailing Address - Fax:
Practice Address - Street 1:3340 BROOKDALE DR N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55443-2863
Practice Address - Country:US
Practice Address - Phone:763-280-3236
Practice Address - Fax:888-588-3166
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2271497163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse