Provider Demographics
NPI:1265626147
Name:KEARNEY-BIDWELL, KATHERINE ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:KEARNEY-BIDWELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-2218
Mailing Address - Country:US
Mailing Address - Phone:612-396-4520
Mailing Address - Fax:
Practice Address - Street 1:1667 17TH AVE E
Practice Address - Street 2:SUITE 103B
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-4432
Practice Address - Country:US
Practice Address - Phone:952-445-5250
Practice Address - Fax:952-445-5350
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor