Individual
SUSANNE S MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
10461 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 279-1400
(423) 279-1410
Mailing address
10461 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 279-1400
(423) 279-1410
Taxonomy
Speciality
Code
Description
License number
State
163WG0100X
Gastroenterology Registered Nurse
Primary
5221
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3908885
—
TN
Enumeration date
08/09/2005
Last updated
10/01/2015
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