Provider Demographics
NPI:1891389656
Name:KEMMERLIN, AMY GUNN (NP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:GUNN
Last Name:KEMMERLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2711 RANDOLPH RD STE 400
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-2027
Mailing Address - Country:US
Mailing Address - Phone:707-342-9577
Mailing Address - Fax:704-377-0353
Practice Address - Street 1:2711 RANDOLPH RD STE 400
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2027
Practice Address - Country:US
Practice Address - Phone:707-342-9577
Practice Address - Fax:704-377-0353
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5014627363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily