Provider Demographics
NPI:1124407416
Name:HEMANN, SUSAN (OD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HEMANN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 E 125TH ST
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-3137
Mailing Address - Country:US
Mailing Address - Phone:507-254-5036
Mailing Address - Fax:
Practice Address - Street 1:6601 LYNDALE AVE S STE 160
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2690
Practice Address - Country:US
Practice Address - Phone:612-869-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3483152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist