Healthcare Provider Details

I. General information

NPI: 1144866963
Provider Name (Legal Business Name): JENNIFER TEMPEST FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2019
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 S LAPEER RD
LAKE ORION MI
48360-1437
US

IV. Provider business mailing address

1428 S LAPEER RD
LAKE ORION MI
48360-1437
US

V. Phone/Fax

Practice location:
  • Phone: 248-693-0543
  • Fax:
Mailing address:
  • Phone: 248-845-4237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number237226
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number237226
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: