Provider Demographics
NPI:1093083420
Name:HEMINGWAY, KENYA KAWANEE (FNP)
Entity Type:Individual
Prefix:DR
First Name:KENYA
Middle Name:KAWANEE
Last Name:HEMINGWAY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1858 W 35TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-1201
Mailing Address - Country:US
Mailing Address - Phone:773-940-2062
Mailing Address - Fax:773-940-2061
Practice Address - Street 1:1858 W 35TH ST STE B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609-1201
Practice Address - Country:US
Practice Address - Phone:773-940-2062
Practice Address - Fax:773-940-2061
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041349530163W00000X
174H00000X
IL209009143363LF0000X
IL277000919364SC1501X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health