Provider Demographics
NPI:1447862263
Name:KEMP, LINDSEY ANN
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:ANN
Last Name:KEMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ANN
Other - Last Name:KIENITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4416 GARNER RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:MI
Mailing Address - Zip Code:48701-9750
Mailing Address - Country:US
Mailing Address - Phone:231-287-0643
Mailing Address - Fax:
Practice Address - Street 1:3865 WILDER RD STE 8
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2136
Practice Address - Country:US
Practice Address - Phone:989-324-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI94777204701OtherPRIORITY HEALTH