Provider Demographics
NPI:1528027562
Name:KEMP, NANCY S (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:S
Last Name:KEMP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUTHRIE SQ
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:
Practice Address - Street 1:29 N CHEMUNG ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:NY
Practice Address - Zip Code:14892-1211
Practice Address - Country:US
Practice Address - Phone:670-565-9975
Practice Address - Fax:607-565-2683
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330082-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY500019063OtherRR MEDICARE PIN
NYCC8362OtherRR MEDICARE GROUP
NY01292231Medicare ID - Type Unspecified
S17829Medicare UPIN
NYCC8362OtherRR MEDICARE GROUP