Individual
MS. KIRSTEN JENNISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8455 FLYING CLOUD DR, EDEN PRAIRIE, MN 55344-3974
(952) 993-7400
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11755
MN
Other
Enumeration date
12/10/2014
Last updated
10/06/2023
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