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

Kennedy Bergren, PA-C

Individual provider Physician Assistant · NPI 1063361103

Kennedy Bergren, PA-C is a Physician Assistant in Coon Rapids, Minnesota. Licensed in Minnesota. Registered with an NPI since 2026.

Licensed in
MN
In the registry since
2026
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone: (763) 780-9155
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 15701 (MN)

Record details

NPI number1063361103
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 22, 2026
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026

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