Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 1507 | MN |
NPI | 1902020258 |
---|---|
Provider Name | Dr. Susan Kay Kranz |
First Address | Shoreview, MN 55126-8082 |
Second Address | Shoreview, MN 55126-8082 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |