Healthcare Provider Details

I. General information

NPI: 1356345730
Provider Name (Legal Business Name): MICHELLE L. KEMPF F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 DODGE ST
BEDFORD IA
50833-1413
US

IV. Provider business mailing address

114 E SOUTH HILLS DR
MARYVILLE MO
64468-2659
US

V. Phone/Fax

Practice location:
  • Phone: 712-523-2738
  • Fax: 712-523-3256
Mailing address:
  • Phone: 660-562-2525
  • Fax: 660-562-4303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number146102
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA097842
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: