Healthcare Provider Details

I. General information

NPI: 1902537301
Provider Name (Legal Business Name): ANNA MEILING HENNEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNA MEILING OLSON PA-C

II. Dates (important events)

Enumeration Date: 06/17/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 W 78TH ST STE 230
EDINA MN
55439-2570
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 952-946-9777
  • Fax: 952-946-9888
Mailing address:
  • Phone: 612-262-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number14083
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: