Provider Demographics
NPI:1508262379
Name:LEMPKA, KATHLEEN
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:LEMPKA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:D
Other - Last Name:LEMPKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:133 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-6546
Mailing Address - Country:US
Mailing Address - Phone:845-775-4048
Mailing Address - Fax:
Practice Address - Street 1:55 OLD TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2461
Practice Address - Country:US
Practice Address - Phone:845-613-7838
Practice Address - Fax:845-624-0264
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112022164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse