Individual
TAYLOR KENEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 232-7348
Mailing address
2829 UNIVERSITY AVE SE STE 730, MINNEAPOLIS, MN 55414-3279
(612) 439-1868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14803
MN
Other
Enumeration date
01/12/2024
Last updated
04/01/2025
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