Provider Demographics
NPI:1952144198
Name:KEMPER, KAMRYN (OD)
Entity type:Individual
Prefix:
First Name:KAMRYN
Middle Name:
Last Name:KEMPER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12412 RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-4605
Mailing Address - Country:US
Mailing Address - Phone:952-451-9937
Mailing Address - Fax:
Practice Address - Street 1:355 S WADSWORTH BLVD UNIT D
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3136
Practice Address - Country:US
Practice Address - Phone:720-962-6906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0004032152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist