Healthcare Provider Details

I. General information

NPI: 1730501313
Provider Name (Legal Business Name): TIFFANIE MICHELLE KEMP CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 WHITEFORD RD UNIT 1
YORK PA
17402-8992
US

IV. Provider business mailing address

14 ICE HOUSE DR
STEWARTSTOWN PA
17363-4116
US

V. Phone/Fax

Practice location:
  • Phone: 717-791-2590
  • Fax: 717-221-5466
Mailing address:
  • Phone: 717-578-3325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP013184
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: