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General NPI Number Information
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NPI Number | 1396839007
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Entity Type | Individual
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Provider Name | KENNETH DUANE KEMP MD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/21/2018
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Provider Practice Location Address
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Address Line | 2162 BOULDER RD
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City | CHANHASSEN
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State | MN
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Zip | 55317-7402
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Country | US
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Telephone | 952-474-7606
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Fax |
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Provider Business Mailing Address
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Address Line | 2162 BOULDER ROAD
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City | CHANHASSEN
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State | MN
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Zip | 55317
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Country | US
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Telephone | 952-474-7606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34403
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License Number State | MN
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