Individual
AMANDA KOHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
2428 EAST 117TH ST, BURNSVILLE, MN 55337
(612) 444-3000
(612) 444-9000
Mailing address
2428 EAST 117TH ST, BURNSVILLE, MN 55337
(612) 444-3000
(612) 444-9000
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
13622
MN
363A00000X
Physician Assistant
Primary
13662
MN
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
13662
MN
Other
Enumeration date
07/29/2020
Last updated
04/13/2026
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