Healthcare Provider Details

I. General information

NPI: 1790005692
Provider Name (Legal Business Name): ERIN E KEMPE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 CARIBOU DR STE 200
FORT COLLINS CO
80525-4388
US

IV. Provider business mailing address

2014 CARIBOU DR STE 200
FORT COLLINS CO
80525-4388
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-1681
  • Fax: 970-221-0948
Mailing address:
  • Phone: 970-221-1681
  • Fax: 970-221-0948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number34-010925
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34-010925
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number34-010925
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberCDRH.56391
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: