Provider Demographics
NPI:1396072773
Name:KEMP, MISCHELLE R (NP)
Entity type:Individual
Prefix:
First Name:MISCHELLE
Middle Name:R
Last Name:KEMP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MISCHELLE
Other - Middle Name:R
Other - Last Name:MORRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:331 SIJEN AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEMAN AFB
Mailing Address - State:MO
Mailing Address - Zip Code:65305-1269
Mailing Address - Country:US
Mailing Address - Phone:660-687-2811
Mailing Address - Fax:
Practice Address - Street 1:606 S HARDY AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64053-1827
Practice Address - Country:US
Practice Address - Phone:816-404-5770
Practice Address - Fax:816-404-5771
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002002325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily