Individual provider · Type 1 NPI

Kennedy Bergren, PA-C

Physician Assistant · Coon Rapids, MN

NPI number 1063361103 Active

Practice location

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841

Call (763) 780-9155 Map

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X15701 (MN)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1063361103

Kennedy Bergren, PA-C's National Provider Identifier is 1063361103, issued on Jan 22, 2026. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Coon Rapids, MN. The record was last updated on May 5, 2026.