Healthcare Provider Details

I. General information

NPI: 1396503637
Provider Name (Legal Business Name): ERIN ELIZABETH KEMPF PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 S 18TH ST
PLATTSMOUTH NE
68048-2056
US

IV. Provider business mailing address

11266 BAUMAN AVE
OMAHA NE
68164-6807
US

V. Phone/Fax

Practice location:
  • Phone: 402-296-2800
  • Fax:
Mailing address:
  • Phone: 816-878-7589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number1762
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number1762
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: