Provider Demographics
NPI:1235217118
Name:KENNEY, SEAN PATRICK (MD)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:PATRICK
Last Name:KENNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S 48TH ST
Mailing Address - Street 2:SUITE 712
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1276
Mailing Address - Country:US
Mailing Address - Phone:402-483-8485
Mailing Address - Fax:402-483-8486
Practice Address - Street 1:1500 S 48TH ST
Practice Address - Street 2:SUITE 712
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1276
Practice Address - Country:US
Practice Address - Phone:402-483-8485
Practice Address - Fax:402-483-8486
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19291207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025718000Medicaid
NE10026464400Medicaid
NE10025266200Medicaid
NEG36309Medicare UPIN
NE099570020Medicare PIN
NE099720Medicare PIN