Healthcare Provider Details

I. General information

NPI: 1124035266
Provider Name (Legal Business Name): PAMELA HELEN-HEILGE KEMPERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 10/19/2020
Certification Date: 10/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BREAKTHROUGH WAY
LAS VEGAS NV
89135-3011
US

IV. Provider business mailing address

10170 W TROPICANA AVE # 156-252
LAS VEGAS NV
89147-8465
US

V. Phone/Fax

Practice location:
  • Phone: 702-732-1493
  • Fax: 702-732-1080
Mailing address:
  • Phone: 702-732-1493
  • Fax: 702-732-1080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberG35851
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number19585
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: