Provider Demographics
NPI:1922660653
Name:KEMP, SUSAN FROBOS (NP-C)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:FROBOS
Last Name:KEMP
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:CROOM
Other - Last Name:FROBOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:PO BOX 742616
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2616
Mailing Address - Country:US
Mailing Address - Phone:770-219-8420
Mailing Address - Fax:
Practice Address - Street 1:200 S ENOTA DR NE STE 380
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3475
Practice Address - Country:US
Practice Address - Phone:770-219-5779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN250556363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily