Individual
KARIN KENYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
14700 28TH AVE N STE 20, PLYMOUTH, MN 55447-4876
(763) 559-3779
Mailing address
PO BOX 47159, PLYMOUTH, MN 55447-0159
(763) 559-3779
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 115003-0
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33A01LI
BCBSMN
MN
05
—
658717800
—
MN
Enumeration date
08/12/2005
Last updated
10/08/2018
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