Healthcare Provider Details

I. General information

NPI: 1003129107
Provider Name (Legal Business Name): ROBYN RACHELLE KEMPF PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3910 MINNESOTA AVE
DULUTH MN
55802-2553
US

IV. Provider business mailing address

908 W MAGNOLIA ST
KISSIMMEE FL
34741-4117
US

V. Phone/Fax

Practice location:
  • Phone: 218-727-8933
  • Fax:
Mailing address:
  • Phone: 407-730-8970
  • Fax: 407-730-8971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9105591
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15208
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number029470
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: