Provider Demographics
NPI:1053746883
Name:MCKEEVER, SUZANNE (MS, RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:MCKEEVER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 HUNTINGDON RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4312
Mailing Address - Country:US
Mailing Address - Phone:215-896-2533
Mailing Address - Fax:
Practice Address - Street 1:2400 HUNTINGDON RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4312
Practice Address - Country:US
Practice Address - Phone:215-896-2533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA925560133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered