Pemberton, Kenisha Shawnta

Pemberton, Kenisha Shawnta is an individual health care provider with primary practice located at 4430 Missouri Ave , Fort Leonard Wood MO 65473-9098. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Pemberton, Kenisha Shawnta can be contacted via phone (573) 596-0417.

Contact Information

Primary practice address
4430 Missouri Ave Fort Leonard Wood MO 65473-9098
Phone: (573) 596-0417
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME117245 Florida

Profile Details

NPI number 1114289907
LBN Legal business name Pemberton, Kenisha Shawnta
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2012
Last updated Jun 14th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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