Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 8281 | NC |
N | 1223G0001X | General Practice | 8281 | NC |
N | 213EG0000X | General Practice | 8281 | NC |
NPI | 1114060571 |
---|---|
Provider Name | Dr. Audrey Kemp |
First Address | Durham, NC 27713-3141 |
Second Address | Prospect Hill, NC 27314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 07/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5917625 | (05) | NC |