Provider Demographics
NPI:1821830969
Name:KEMP, LAUREN R (STNA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:R
Last Name:KEMP
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1771 FREEMAN ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-4446
Mailing Address - Country:US
Mailing Address - Phone:916-287-6766
Mailing Address - Fax:
Practice Address - Street 1:1771 FREEMAN ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-4446
Practice Address - Country:US
Practice Address - Phone:916-287-6766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH601642231020376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide