Provider Demographics
NPI:1932317161
Name:SCHUR, JEANNE MARIE (PHD,LP)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:MARIE
Last Name:SCHUR
Suffix:
Gender:F
Credentials:PHD,LP
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:M
Other - Last Name:SCHUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD,LP, INC
Mailing Address - Street 1:5308 W 70TH ST
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2000
Mailing Address - Country:US
Mailing Address - Phone:952-921-5827
Mailing Address - Fax:
Practice Address - Street 1:3800 AMERICAN BLVD W STE 1500
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-4429
Practice Address - Country:US
Practice Address - Phone:952-921-5827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2155103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN918050800Medicaid