Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 216985 | MA |
N | 2080P0207X | Pediatric Hematology-Oncologist | 216985 | MA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 48930 | MN |
NPI | 1154375061 |
---|---|
Provider Name | Susan Lynn Kearney |
First Address | Minneapolis, MN 55404 |
Second Address | Minneapolis, MN 55404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 11/12/2012 |