Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN120553 | GA |
NPI | 1003119207 |
---|---|
Provider Name | Ms. Deborah Evelyn Kemp |
First Address | Savannah, GA 31405-4493 |
Second Address | Savannah, GA 31405-4492 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2010 |
Last Update Date | 04/02/2021 |