Provider Demographics
NPI:1477856581
Name:KEMPERS, HOLLY MARIE (APNP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:MARIE
Last Name:KEMPERS
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 N SWEETWATER BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-2657
Mailing Address - Country:US
Mailing Address - Phone:920-476-6400
Mailing Address - Fax:
Practice Address - Street 1:115 N SWEETWATER BLVD
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:WI
Practice Address - Zip Code:53074-2657
Practice Address - Country:US
Practice Address - Phone:920-476-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-10
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4257-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner