Provider Demographics
NPI:1316257645
Name:KEMPF, BROOKE ANNE (PMHNP)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ANNE
Last Name:KEMPF
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 MCFADDEN LN
Mailing Address - Street 2:
Mailing Address - City:BRAZIL
Mailing Address - State:IN
Mailing Address - Zip Code:47834-9230
Mailing Address - Country:US
Mailing Address - Phone:812-208-2803
Mailing Address - Fax:812-231-8187
Practice Address - Street 1:620 8TH AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-2744
Practice Address - Country:US
Practice Address - Phone:812-231-8401
Practice Address - Fax:812-231-8187
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003420A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71003420AOtherAPN PRESCRIPTIVE AUTHORITY NUMBER