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Individual

DESIREE MARIE KEMPCKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3250 W 66TH ST, SUITE 100, EDINA, MN 55435-2528
(952) 920-0970
(952) 922-1605
Mailing address
6465 WAYZATA BLVD, SUITE 900, ST LOUIS PARK, MN 55426-1728
(952) 512-5600
(952) 512-5650

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
36583
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
550S9KE
BLUE CROSS BLUE SHIELD
01
82507000
WISC MEDICAID
01
907605
MEDICA
01
969991000270
PREFERREDONE
01
HP13577
HEALTHPARTNERS
Enumeration date
08/29/2006
Last updated
07/10/2007
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