Individual
JEFFREY KEARNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LP
Contact information
Practice address
3812 8TH ST N STE 200, SAINT CLOUD, MN 56303-1421
(320) 258-3833
(320) 253-5741
Mailing address
3812 8TH ST N STE 200, SAINT CLOUD, MN 56303-1413
(320) 258-3833
(320) 253-5741
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP3727
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1015046
PREFERRED ONE
MN
01
—
167303
UCARE
MN
01
—
2028601
BLUE CROSS
MN
01
—
268J3KE
BLUES
MN
01
—
6174715
MEDICA
MN
01
—
88805
GROUP HEALTH
MN
05
—
902716500
—
MN
Enumeration date
05/01/2006
Last updated
11/13/2024
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