Provider Demographics
NPI:1972572873
Name:KEMPF, MARY J (CNM)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:J
Last Name:KEMPF
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:J
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:9321 HILLINGDON RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3583
Mailing Address - Country:US
Mailing Address - Phone:651-714-8572
Mailing Address - Fax:
Practice Address - Street 1:1983 SLOAN PL
Practice Address - Street 2:SUITE 1
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-2087
Practice Address - Country:US
Practice Address - Phone:651-326-5700
Practice Address - Fax:651-326-5715
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR113649-4176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP51288Medicare UPIN