Mitchell, Kenneth Allen
Mitchell, Kenneth Allen is an individual health care provider with primary practice located at 6025 Lake Rd Suite 200, Woodbury MN 55125-1712. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mitchell, Kenneth Allen can be contacted via phone (651) 999-6800.Contact Information
Primary practice address
6025 Lake Rd Suite 200
Woodbury MN 55125-1712
Phone: (651) 999-6800
Fax: (651) 999-6830
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA970 | Arkansas |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 10025 | Minnesota |
Profile Details
| NPI number | 1922096379 |
|---|---|
| LBN Legal business name | Mitchell, Kenneth Allen |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2005 |
| Last updated | Apr 5th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922096379 | NPPES |
| Minnesota | MEDICAID | 534141800 |
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