Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kendall Anne Koenen

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1356119564

Kendall Anne Koenen is a Physician Assistant in St Louis Park, Minnesota. Qualified in 2023, 3 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
3
Licensed in
MN
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone: (952) 993-3123
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 13310 58th Ave N Apt F, Plymouth, MN 55442-1680 — (612) 968-2881

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14768 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1356119564
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 18, 2023
Last updated in NPPESFebruary 23, 2024
Certification dateFebruary 23, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in St Louis Park