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General NPI Number Information
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NPI Number | 1558453472
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Entity Type | Individual
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Provider Name | BOBBY CHARLES KEMP CRNP
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 24245 5TH AVE
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City | FLORALA
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State | AL
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Zip | 36442-3523
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Country | US
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Telephone | 334-858-2050
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Fax | 334-858-2120
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Provider Business Mailing Address
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Address Line | P.O. BOX 1255 644 ADAMS STREET
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City | PAXTON
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State | FL
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Zip | 32538-1255
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Country | US
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Telephone | 850-834-3722
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-054821
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License Number State | AL
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