1720171556 NPI number — JOHN E HESS ARNP

Table of content: JOHN E HESS ARNP (NPI 1720171556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720171556 NPI number — JOHN E HESS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HESS
Provider First Name:
JOHN
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
M

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:
1720171556
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4735 ADRIENNE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEBRING
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33872-1710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-221-0501
Provider Business Mailing Address Fax Number:
520-387-6036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4735 ADRIENNE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEBRING
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33872-1710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-221-0501
Provider Business Practice Location Address Fax Number:
520-387-6036
Provider Enumeration Date:
10/02/2006

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: 363L00000X , with the licence number:  ARNP9206510 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: ARNP9206510 , 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)

  • Identifier: ARNP9206510 . This is a "LICENSE NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: A0806308 . This is a "NP-C" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 307964300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 366988 . This is a "HEALTHEASE/HEALTHYKIDS" identifier . This identifiers is of the category "OTHER".
  • Identifier: SSN . This is a "TRICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1720171556 . This is a "NPI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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