Provider Demographics
NPI:1497469712
Name:KEMP, DANIELLE LORRAINE (CMS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LORRAINE
Last Name:KEMP
Suffix:
Gender:F
Credentials:CMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 STATE ROUTE 152
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:OH
Mailing Address - Zip Code:43910-7997
Mailing Address - Country:US
Mailing Address - Phone:740-461-0504
Mailing Address - Fax:
Practice Address - Street 1:1401 STATE ROUTE 152
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:OH
Practice Address - Zip Code:43910-7997
Practice Address - Country:US
Practice Address - Phone:740-461-0504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist