Colgan, Kimen M

Colgan, Kimen M is an individual health care provider with primary practice located at 575 Price St Suite101, Pismo Beach CA 93449-2553. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Colgan, Kimen M can be contacted via phone (805) 481-3685.

Contact Information

Primary practice address
575 Price St Suite101 Pismo Beach CA 93449-2553
Phone: (805) 481-3685
Fax: (805) 481-5245
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1366 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3531 Arizona

Profile Details

NPI number 1699739227
LBN Legal business name Colgan, Kimen M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2006
Last updated Sep 19th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699739227 NPPES
Wisconsin MEDICAID 41929300

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