Provider Demographics
NPI:1235502394
Name:KEMP, SEAN
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:KEMP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8330 E QUINCY AVE
Mailing Address - Street 2:E312
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2405
Mailing Address - Country:US
Mailing Address - Phone:303-434-2771
Mailing Address - Fax:
Practice Address - Street 1:8330 E QUINCY AVE
Practice Address - Street 2:E312
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2405
Practice Address - Country:US
Practice Address - Phone:303-434-2771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO020390513251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable