MEDICARE: MS. LAJUANA NICHOLE KEMPER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker		OH
2	171WH0202X	Home Modifications Contractor

General Provider Information

NPI Number	:	1528747987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAJUANA NICHOLE KEMPER

Provider Business Mailing Address
First Line	:	3142 W TOWER AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-3412
Country	:	US
Telephone Number	:	513-378-9982
Fax Number	:

Provider Business Practice Location Address
First Line	:	5655 RED CEDAR DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-3263
Country	:	US
Telephone Number	:	513-378-9982
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2023
Last Update Date	:	07/13/2023

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