Provider Demographics
NPI:1962789255
Name:COLLINS, MICHAELA RICE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MICHAELA
Middle Name:RICE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:MICHAELA
Other - Middle Name:RICE
Other - Last Name:WASZGIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2802 OAK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5604
Mailing Address - Country:US
Mailing Address - Phone:402-334-7546
Mailing Address - Fax:402-334-8627
Practice Address - Street 1:2802 OAK VIEW DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5604
Practice Address - Country:US
Practice Address - Phone:402-334-7546
Practice Address - Fax:402-334-8627
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1595363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant