Provider Demographics
NPI:1598562282
Name:LYKSETT, CONNOR BERN (PA-C)
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:BERN
Last Name:LYKSETT
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 WABASHA ST S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-1805
Practice Address - Country:US
Practice Address - Phone:952-967-5584
Practice Address - Fax:651-293-8232
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN15307363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant