1346774650 NPI number — MRS. DEMERE KASPER HESS FNP-BC

Table of content: MRS. DEMERE KASPER HESS FNP-BC (NPI 1346774650)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346774650 NPI number — MRS. DEMERE KASPER HESS FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HESS
Provider First Name:
DEMERE
Provider Middle Name:
KASPER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346774650
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5215 LOUGHBORO RD NW STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20016-2626
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-660-5191
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5255 LOUGHBORO RD NW
Provider Second Line Business Practice Location Address:
BUILDING B, GROUND FLOOR
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20016-2633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-660-5766
Provider Business Practice Location Address Fax Number:
202-537-4442
Provider Enumeration Date:
04/13/2017

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: 363LF0000X , with the licence number:  R233611 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: RN1043109 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: R233611 . This is a "MD BON" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: RN1043109 . This is a "DC DOH" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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