Provider Demographics
NPI:1467644948
Name:KEMP, COREY DONTE (RN)
Entity Type:Individual
Prefix:MR
First Name:COREY
Middle Name:DONTE
Last Name:KEMP
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3713 CASTLE CT
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-2979
Mailing Address - Country:US
Mailing Address - Phone:330-881-3077
Mailing Address - Fax:
Practice Address - Street 1:4611 DEER CREEK CT
Practice Address - Street 2:APT 10
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-5473
Practice Address - Country:US
Practice Address - Phone:330-881-3077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2009-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.329169163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse