1003801242 NPI number — MRS. HEATHER ANN NEWMAN CRNA

Table of content: MRS. HEATHER ANN NEWMAN CRNA (NPI 1003801242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003801242 NPI number — MRS. HEATHER ANN NEWMAN CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEWMAN
Provider First Name:
HEATHER
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEMBO
Provider Other First Name:
HEATHER
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003801242
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2841 BLUE SPRINGS PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESLEY CHAPEL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33543-8746
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-907-0563
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6TH MEDICAL GROUP/SGHC
Provider Second Line Business Practice Location Address:
8415 BAYSHORE BLVD
Provider Business Practice Location Address City Name:
MACDILL AFB
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-827-9350
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/14/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  ARNP 9228539 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)