Provider Demographics
NPI:1679871586
Name:FLUGEL COLLE, KATHLEEN FRANCETTE (PMH-CNS, BC, APRN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:FRANCETTE
Last Name:FLUGEL COLLE
Suffix:
Gender:F
Credentials:PMH-CNS, BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3253 19TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-6798
Mailing Address - Country:US
Mailing Address - Phone:507-280-0690
Mailing Address - Fax:
Practice Address - Street 1:3253 19TH ST NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-6798
Practice Address - Country:US
Practice Address - Phone:507-280-0690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2010010963364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult