Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 71008046B | IN |
NPI | 1114414448 |
---|---|
Provider Name | Caitlin Kemp |
First Address | Terre Haute, IN 47802-3503 |
Second Address | Indianapolis, IN 46202-5187 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2018 |
Last Update Date | 14/12/2021 |