Provider Demographics
NPI:1851693444
Name:KEMP, MARYHELEN M (RN)
Entity Type:Individual
Prefix:MISS
First Name:MARYHELEN
Middle Name:M
Last Name:KEMP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:MARYHELEN
Other - Middle Name:H
Other - Last Name:MCCALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 16068
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27261-6068
Mailing Address - Country:US
Mailing Address - Phone:888-447-7220
Mailing Address - Fax:
Practice Address - Street 1:1059 NEAL STREET
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501
Practice Address - Country:US
Practice Address - Phone:931-646-7058
Practice Address - Fax:931-646-7059
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000015362367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4284593OtherBCBS
1326171794OtherGROUP NPI
TN1522195Medicaid
TN3629275Medicaid
621714950OtherTAX ID
621714950OtherTAX ID
TN3629275Medicaid