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General NPI Number Information
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NPI Number | 1154927879
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Entity Type | Individual
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Provider Name | ALLISON RENAE KEY MSM, PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 6160 SUMMIT DR N STE 450
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2121
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Country | US
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Telephone | 763-503-8560
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Fax | 763-503-8563
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Provider Business Mailing Address
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Address Line | 4240 PARK GLEN RD
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-5427
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Country | US
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Telephone | 612-925-6033
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Fax | 612-925-8496
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA13518
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 14631
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License Number State | MN
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