Healthcare Provider Details

I. General information

NPI: 1801097928
Provider Name (Legal Business Name): FAMILY MEDICINE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W LEOTA ST STE 100
NORTH PLATTE NE
69101-6578
US

IV. Provider business mailing address

500 W LEOTA ST STE 100
NORTH PLATTE NE
69101-6578
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-4440
  • Fax: 308-534-7675
Mailing address:
  • Phone: 308-534-4440
  • Fax: 308-534-7675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA ANN KEMPKE
Title or Position: OFFICE MANAGER
Credential:
Phone: 308-534-4440