Basic Information
| Provider Information | |||||||||
| NPI: | 1306248646 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEMP-MAJOR | ||||||||
| FirstName: | ANITRA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MSN, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 522 TORRENCE AVE | ||||||||
| Address2: | |||||||||
| City: | CALUMET CITY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604093216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7087302200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 522 TORRENCE AVE | ||||||||
| Address2: | |||||||||
| City: | CALUMET CITY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604093216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7087302200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2014 | ||||||||
| LastUpdateDate: | 07/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 209011553 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 209011553 | 01 | IL | APN LICENSE NUMBER | OTHER |