Individual
MACKENZIE LEA KUSILEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5715 MEMORIAL AVE N, OAK PARK HEIGHTS, MN 55082-1093
(651) 439-8807
(651) 439-0232
Mailing address
3500 AMERICAN BLVD W STE 300, BLOOMINGTON, MN 55431-4442
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15180
MN
363A00000X
Physician Assistant
50.005906RX
OH
363A00000X
Physician Assistant
8208-23
WI
Other
Enumeration date
01/17/2019
Last updated
03/09/2026
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