Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | OS011819 | PA |
NPI | 1306843149 |
---|---|
Provider Name | Dr. Shannon Kearney |
First Address | Bethlehem, PA 18017-7804 |
Second Address | Bethlehem, PA 18017-7804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 07/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I25066 | (02) | PA |