Provider Demographics
NPI:1184290140
Name:HOWARDKEMP, PRINCETTA MARIE
Entity type:Individual
Prefix:
First Name:PRINCETTA
Middle Name:MARIE
Last Name:HOWARDKEMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8239 HONEY LN
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4101
Mailing Address - Country:US
Mailing Address - Phone:734-897-7572
Mailing Address - Fax:
Practice Address - Street 1:8239 HONEY LN
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4101
Practice Address - Country:US
Practice Address - Phone:734-897-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704359953164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse