Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENZIE JACKLEY, PHYSICIAN ASSISTANT
ActiveKENZIE JACKLEY, PHYSICIAN ASSISTANT is a Physician Assistant healthcare provider located in EDINA, Minnesota. NPI 1396142568 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · EDINA, MN
Registration Details
- NPI Number
- 1396142568
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 3, 2014 (11.660475243519 yrs)
- Last Updated
- Nov 3, 2020
- License
-
11821 (MN)
Practice Information
- Address
-
6700 FRANCE AVE SSUITE 300EDINA, MN, 554351902Browse MN providers · Browse ZIP 55435
- Phone
- 9523453000
- Fax
- 9523456789
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in EDINA, MN
| Name | Credential | NPI |
|---|---|---|
| MR. MATTHEW C HAWKINS | P.A.-C. | 1043293673 |
| MRS. KARI K LARSON | PA-C | 1972588879 |
| MS. CHERYL LYNN OELTJENBRUNS | PAC | 1194701102 |
| LARRY NILSSON | PA-C | 1033197595 |
| STEVEN B VANDONSELAAR | PA-C | 1659345783 |
| MS. BRENDA JOY BAKER | P.A.C | 1417922873 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.