1750646568 NPI number — MRS. KATHRYN REYNOLDS KEMPH WHNP

Table of content: MRS. KATHRYN REYNOLDS KEMPH WHNP (NPI 1750646568)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750646568 NPI number — MRS. KATHRYN REYNOLDS KEMPH WHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KEMPH
Provider First Name:
KATHRYN
Provider Middle Name:
REYNOLDS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
WHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
REYNOLDS
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
PAIGE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
WHNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750646568
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5101 JOSEPH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THE COLONY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75056
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-276-3582
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3901 W 15TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75075-7738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-276-3582
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  AP134892 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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