Provider Demographics
NPI:1457356875
Name:KEMP, STACEY A (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:A
Last Name:KEMP
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 S STATE ST
Mailing Address - Street 2:742 BUILDING
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-674-3970
Mailing Address - Fax:302-672-2350
Practice Address - Street 1:517 S DUPONT HWY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1757
Practice Address - Country:US
Practice Address - Phone:302-424-6511
Practice Address - Fax:302-424-6513
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELH00000142363LW0102X
DELH-0000142363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000932842Medicaid
DE0000932842Medicaid
DE002819B15Medicare ID - Type UnspecifiedMEDICARE #