Basic Information
| Provider Information | |||||||||
| NPI: | 1548884471 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KEMP | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | KAYE | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 924 EDWARD AVE | ||||||||
| Address2: | |||||||||
| City: | JEFFERSON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305497295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7706309358 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2620 OLD WINDER HWY | ||||||||
| Address2: | |||||||||
| City: | BRASELTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305176105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788212401 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2020 | ||||||||
| LastUpdateDate: | 06/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN248035 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.