Provider Demographics
NPI:1629490719
Name:MAGILL-COLLINS, ANNE (PA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:MAGILL-COLLINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1373
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:CO
Mailing Address - Zip Code:80442-1373
Mailing Address - Country:US
Mailing Address - Phone:970-531-1000
Mailing Address - Fax:
Practice Address - Street 1:1450 ELLIS ST STE 201
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8813
Practice Address - Country:US
Practice Address - Phone:406-587-0122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant