Provider Demographics
NPI:1588047096
Name:AYA, KESSIENA (DO)
Entity type:Individual
Prefix:DR
First Name:KESSIENA
Middle Name:
Last Name:AYA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KESSIENA
Other - Middle Name:
Other - Last Name:AYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1873 10TH AVE E APT 218
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-2646
Mailing Address - Country:US
Mailing Address - Phone:320-480-0001
Mailing Address - Fax:320-525-1234
Practice Address - Street 1:95 S 10TH ST APT 1107TH
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2431
Practice Address - Country:US
Practice Address - Phone:320-480-0001
Practice Address - Fax:320-525-1234
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX592772207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery