MEDICARE: JEANNINE KEMP NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	95003911	CA

General Provider Information

NPI Number	:	1417253550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNINE KEMP NP

Provider Business Mailing Address
First Line	:	601 E DAILY DR STE 228
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-5840
Country	:	US
Telephone Number	:	805-914-0637
Fax Number	:	805-693-4327

Provider Business Practice Location Address
First Line	:	601 E DAILY DR STE 228
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-5840
Country	:	US
Telephone Number	:	805-914-0637
Fax Number	:	805-693-4327

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2011
Last Update Date	:	08/30/2024

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