Provider Demographics
NPI:1184092272
Name:KEMP, ADRIENNE (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:KEMP
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:DIANE
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 DANDELION CIR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-3717
Mailing Address - Country:US
Mailing Address - Phone:404-477-7390
Mailing Address - Fax:
Practice Address - Street 1:270 W LAKE MEAD PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7093
Practice Address - Country:US
Practice Address - Phone:702-877-5199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA168226363LF0000X
NV825719363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily