Provider Demographics
NPI:1033155205
Name:KEMPER, BETTY JANE (CRNA)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:JANE
Last Name:KEMPER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:KEMPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:1403 50TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55430-4515
Mailing Address - Country:US
Mailing Address - Phone:701-720-6422
Mailing Address - Fax:
Practice Address - Street 1:800 E 28TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3723
Practice Address - Country:US
Practice Address - Phone:865-342-8940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCRNA1245367500000X
MNCRNA 1919367500000X
NE101290367500000X
NDR26125367500000X
SDCR000645367500000X, 367500000X
IL209020563367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered