Susan M. McKillip, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN067339 Issued in AZ

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(866) 799-5886

NPI assigned

Dec 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1821152034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 W PARK AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335135",
            "telephone_number": "480-507-5715",
            "fax_number": "480-633-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "866-799-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKILLIP",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN067339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383703",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Joy McIntosh
• Dawn McKee
• Bernadette McKenna, MA
• Margaret Ann McKenzie, CFNP
• Sydney McKenzie
• Ralph Edmond McKinney, PHD
• Claire McKissick, M.A. CCC-SLP
• MCL Psychological, Inc.
• Natalie Renee McLendon, MSN, APRN, FNP-BC
• Josephine Rose McMurtry

• Family Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.