Provider Demographics
NPI:1427051499
Name:KEMP, LAURA L (CNM)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:KEMP
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 VAN BUREN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830-1534
Mailing Address - Country:US
Mailing Address - Phone:419-435-4950
Mailing Address - Fax:419-435-0849
Practice Address - Street 1:501 VAN BUREN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:FOSTORIA
Practice Address - State:OH
Practice Address - Zip Code:44830-1534
Practice Address - Country:US
Practice Address - Phone:419-435-4950
Practice Address - Fax:419-435-0849
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN183006367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2530434Medicaid
OHQ30947Medicare UPIN
OHH119300Medicare PIN
OH2530434Medicaid