MEDICARE: MRS. GINNY WARREN KEMP L.P.C.

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	101Y00000X	Counselor	0455	MS

General Provider Information

NPI Number	:	1760780316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GINNY WARREN KEMP L.P.C.

Provider Business Mailing Address
First Line	:	5 ASHBURY PL
Second Line	:
City	:	COLUMBIA
State	:	MS
Zip	:	39429-3730
Country	:	US
Telephone Number	:	601-543-9393
Fax Number	:

Provider Business Practice Location Address
First Line	:	1113 HIGHWAY 98 BYP STE A
Second Line	:
City	:	COLUMBIA
State	:	MS
Zip	:	39429-3746
Country	:	US
Telephone Number	:	601-543-9393
Fax Number	:

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

Provider Enumeration Date	:	03/07/2011
Last Update Date	:	03/07/2011

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