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

Kenzie Jackley, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1396142568

Kenzie Jackley, PHYSICIANASSISTANT is a Physician Assistant in Edina, Minnesota. Licensed in Minnesota. Registered with an NPI since 2014.

Licensed in
MN
In the registry since
2014

Practice location Address checks out

6700 France Ave S Ste 300
Edina, MN 55435-1902
Phone: (952) 345-3000
Fax: (952) 345-6789
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11821 (MN)

Record details

NPI number1396142568
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedDecember 3, 2014
Last updated in NPPESNovember 3, 2020
Certification dateNovember 3, 2020

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