Individual
JOAN O KEMSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
18308 MURDOCK CIR, UNIT 105, PT CHARLOTTE, FL 33948-1025
(941) 743-4150
(941) 743-4427
Mailing address
4371 VERONICA S SHOEMAKER BLVD, ATTN: CREDENTIALING, FORT MYERS, FL 33916-2216
(239) 274-8200
(239) 278-3350
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103170
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292061100
—
FL
01
—
9308885
CIGNA
FL
01
—
9834304
AETNA
FL
01
—
P01406349
RR MEDICARE
FL
01
—
P04453
FREEDOM
FL
01
—
P959330
OPTIMUM
FL
01
—
Y0NY8
BCBS
FL
Enumeration date
08/13/2006
Last updated
12/03/2015
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