Provider Demographics
NPI:1548926827
Name:KEMPTON, COLLEEN ELLEN (CRNP)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:ELLEN
Last Name:KEMPTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WATERDAM PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2466
Mailing Address - Country:US
Mailing Address - Phone:570-916-2405
Mailing Address - Fax:
Practice Address - Street 1:1001 WATERDAM PLAZA DR
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2466
Practice Address - Country:US
Practice Address - Phone:724-969-1001
Practice Address - Fax:724-260-5448
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN638723163W00000X
PASP028371363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN638723OtherPA STATE BOARD OF NURSING
PASP028371OtherPA STATE BOARD OF NURSING