Provider Demographics
NPI:1851543474
Name:COLLINS, KRISTEN A (CPNP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:A
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:A
Other - Last Name:AUSSIEKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2530 CHICAGO AVE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4289
Mailing Address - Country:US
Mailing Address - Phone:612-813-8006
Mailing Address - Fax:612-813-8005
Practice Address - Street 1:2530 CHICAGO AVE
Practice Address - Street 2:SUITE 550
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4289
Practice Address - Country:US
Practice Address - Phone:612-813-8006
Practice Address - Fax:612-813-8005
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR183535-5363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics