| Jacqueline A Kemp, CRNA | |
|
1050 Division St, Mauston, WI 53948 | |
| (608) 847-6161 | |
| Not Available |
| Full Name | Jacqueline A Kemp |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 12 Years |
| Location | 1050 Division St, Mauston, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194137836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 5846-33 (Wisconsin) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 5846-33 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Divine Savior Healthcare | Portage, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Divine Savior Healthcare Inc | 5799684007 | 94 |
| Entity Name | Mile Bluff Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922145077 PECOS PAC ID: 8527971399 Enrollment ID: O20031107000323 |
| Entity Name | Mile Bluff Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609912005 PECOS PAC ID: 8527971399 Enrollment ID: O20031205000618 |
| Entity Name | Divine Savior Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124083894 PECOS PAC ID: 5799684007 Enrollment ID: O20040225000909 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline A Kemp, CRNA 1050 Division St, Mauston, WI 53948-1931 Ph: (608) 847-6161 | Jacqueline A Kemp, CRNA 1050 Division St, Mauston, WI 53948 Ph: (608) 847-6161 |
August J. Martin, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1050 Division St, Mauston, WI 53948 Phone: 608-847-6161 | |
Mr. Terry Lee Wilson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1050 Division St, Mauston, WI 53948 Phone: 608-847-6161 | |
Donald S. Hart, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1050 Division St, Mauston, WI 53948 Phone: 608-847-6161 | |
Ron Dixon, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1050 Division St, Mauston, WI 53948 Phone: 608-847-6161 | |
Mr. David Scott Lenninger, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1050 Division St, Mauston, WI 53948 Phone: 608-847-6161 Fax: 608-847-3881 |