Provider Demographics
NPI:1174182497
Name:KEMPIS, BERNARD RAMA (NP-C)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:RAMA
Last Name:KEMPIS
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 LASSEN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-4262
Mailing Address - Country:US
Mailing Address - Phone:956-570-4711
Mailing Address - Fax:
Practice Address - Street 1:9201 E MOUNTAIN VIEW RD STE 220
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5172
Practice Address - Country:US
Practice Address - Phone:877-564-3627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010974363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology