Individual
MARIA KEARNEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
4544 COUNTRY ROAD 123 STE 134, ST CLOUD, MN 56303
(320) 258-3833
(320) 253-5741
Mailing address
4544 COUNTRY ROAD 123 STE 134, ST CLOUD, MN 56303
(320) 258-3833
(320) 253-5741
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
3728
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012488
PREFERRED ONE
MN
01
—
167907
UCARE
MN
01
—
20287 01
BLUES MN
MN
01
—
268J2KE
BLUES
MN
01
—
6107709
MEDICA
MN
Enumeration date
05/03/2006
Last updated
07/09/2007
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