Provider Demographics
NPI:1225851140
Name:COLLINS, COLE (RN)
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:
Last Name:COLLINS
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 1:16167 GOODVIEW TRL
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-8964
Mailing Address - Country:US
Mailing Address - Phone:507-291-2521
Mailing Address - Fax:
Practice Address - Street 1:16167 GOODVIEW TRL
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-8964
Practice Address - Country:US
Practice Address - Phone:507-291-2521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2497521163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy