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NPI 1417690785

NPI 1417690785 : COLLIN PERRY MCDOWELL RN, PHN : EDINA, MN

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General NPI Number Information
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    NPI Number           |    1417690785
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    Entity Type          |    Individual 
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    Provider Name        |    COLLIN PERRY MCDOWELL RN, PHN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/15/2022
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    Last Update Date     |    12/19/2025
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Provider Practice Location Address
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    Address Line         |    4660 77TH ST W APT 547 
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    City                 |    EDINA
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    State                |    MN
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    Zip                  |    55435-4239
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    Country              |    US
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    Telephone            |    763-688-0517
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4660 77TH ST W APT 547 
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    City                 |    EDINA
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    State                |    MN
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    Zip                  |    55435-4239
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163W00000X
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    Taxonomy Name        |    Registered Nurse
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    License Number       |    2494536
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    License Number State |    MN
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