Healthcare Provider Details

I. General information

NPI: 1558855908
Provider Name (Legal Business Name): ALESHIANA KEMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 06/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13295 ILLINOIS ST
CARMEL IN
46032-3019
US

IV. Provider business mailing address

5633 BRENDON WAY PKWY
INDIANAPOLIS IN
46226-7243
US

V. Phone/Fax

Practice location:
  • Phone: 317-238-9839
  • Fax:
Mailing address:
  • Phone: 317-238-9839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: