Individual
KENDALL ANNE KOENEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3123
Mailing address
13310 58TH AVE N APT F, PLYMOUTH, MN 55442-1680
(612) 968-2881
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14768
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/18/2023
Last updated
02/23/2024
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