Provider Demographics
NPI:1831317163
Name:COLLINS, ANNETTE M (DC)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14033 COMMERCE AVE NE
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372
Mailing Address - Country:US
Mailing Address - Phone:952-447-0985
Mailing Address - Fax:952-447-0986
Practice Address - Street 1:14033 COMMERCE AVE NE
Practice Address - Street 2:
Practice Address - City:PRIOR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55372
Practice Address - Country:US
Practice Address - Phone:952-447-0985
Practice Address - Fax:952-447-0986
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4285111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN991S9C0OtherBCBS
V05090Medicare UPIN