Shannon Dawn Kinne, L.P.N.

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

307979 Issued in NY

Practice address

15 Suffern PL
Suffern, NY 10901-5566

Phone

(845) 357-4500

NPI assigned

Jan 17, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Shannon Dawn Ruiz Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1295440089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451",
            "city": "MONGAUP VALLEY",
            "state": "NY",
            "postal_code": "127620451",
            "telephone_number": "845-707-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SUFFERN PL",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015566",
            "telephone_number": "845-357-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNE",
        "first_name": "SHANNON",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "L.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "307979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "RUIZ",
            "middle_name": "DAWN",
            "credential": "LPN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sakina Khan, M.D.
• Alla Khlebnikova, RN.
• Daniel J Kilby
• Paul J Kim, DDS
• Susy Anne Kim, RN
• Susan Rita Kirshner, CSW
• Patricia Margaret Kivlehan
• Raizy Klahr, P.A.
• Yaffa Klar, MD
• Carolina Kleiman, RN

• Licensed Practical Nurse in Suffern, NY
• Providers in Suffern, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.