Individual
AMANDA JO KINGZETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 E NICOLLET BLVD, BURNSVILLE, MN 55337-5714
(651) 267-5461
Mailing address
5701 40TH AVE S, MINNEAPOLIS, MN 55417-2923
(651) 301-1623
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1850
MN
363A00000X
Physician Assistant
Primary
1997
MN
Other
Enumeration date
06/27/2006
Last updated
11/11/2013
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