Kenzie Jackley, PHYSICIAN ASSISTANT

NPI #1396142568 in Edina, Minnesota

Provider Information

NPI Number: 1396142568
Entity Type: Individual
Name: Kenzie Jackley, PHYSICIAN ASSISTANT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PHYSICIAN ASSISTANT
Enumeration Date: Dec 3, 2014
Last Updated: Nov 3, 2020

Practice Location

Address: 6700 FRANCE AVE S
Address 2: SUITE 300
City: Edina
State: Minnesota
ZIP Code: 55435-1902
Phone: (952) 345-3000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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