Healthcare Provider Details

I. General information

NPI: 1194336412
Provider Name (Legal Business Name): ANNA KACI ZINNEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA KACI RENNER PA-C

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 SMITH AVE N STE 200
SAINT PAUL MN
55102-2697
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-5111
  • Fax: 651-241-5512
Mailing address:
  • Phone: 612-262-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13479
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: