Provider Demographics
NPI:1255332425
Name:KEMPF, MARSHA (APRN)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:KEMPF
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W NIFONG BLVD
Mailing Address - Street 2:STE 6A
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-6804
Mailing Address - Country:US
Mailing Address - Phone:573-875-5900
Mailing Address - Fax:573-449-6032
Practice Address - Street 1:601 W NIFONG BLVD
Practice Address - Street 2:STE. 6A
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-6804
Practice Address - Country:US
Practice Address - Phone:573-875-5900
Practice Address - Fax:573-449-6032
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112163363LP0808X, 364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO424778827Medicaid
MO424778827Medicaid