Healthcare Provider Details

I. General information

NPI: 1548194913
Provider Name (Legal Business Name): TATIANA KEMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 W CLARK RD APT K2
DEWITT MI
48820-9091
US

IV. Provider business mailing address

PO BOX 22081
LANSING MI
48909-2081
US

V. Phone/Fax

Practice location:
  • Phone: 773-606-1486
  • Fax:
Mailing address:
  • Phone: 773-606-1486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: