Provider Demographics
NPI:1437911252
Name:SIOBHAN KEARNS, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:SIOBHAN KEARNS, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIOBHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEARNS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:516-225-6719
Mailing Address - Street 1:54 PETERSON PL
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3311
Mailing Address - Country:US
Mailing Address - Phone:516-225-8656
Mailing Address - Fax:
Practice Address - Street 1:12 ADAMS ST
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1706
Practice Address - Country:US
Practice Address - Phone:516-225-6719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)