Individual
MELISSA R KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
755 CROSSROADS CAMPUS DR NE, BUFFALO, MN 55313-5074
(763) 684-6300
(763) 684-6305
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9906
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
645076800
—
MN
Enumeration date
04/03/2006
Last updated
05/23/2023
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