Provider Demographics
NPI:1871320267
Name:KEMENNU, RITA AMER (FNP)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:AMER
Last Name:KEMENNU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31189 COUNTRY RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1120
Mailing Address - Country:US
Mailing Address - Phone:619-277-4200
Mailing Address - Fax:
Practice Address - Street 1:31189 COUNTRY RIDGE CIR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1120
Practice Address - Country:US
Practice Address - Phone:619-277-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704366872363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner