Individual
SUSAN K KENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
923 ELIZA ST, GREEN BAY, WI 54301-3234
(920) 965-4800
(920) 341-7024
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
85-156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071050002
MEDICARE PTAN
WI
05
—
41101800
—
WI
Enumeration date
02/15/2007
Last updated
02/24/2016
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