1982889341 NPI number — DONNA K DEMPSEY ARNP PA

Table of content: (NPI 1982889341)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982889341 NPI number — DONNA K DEMPSEY ARNP PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DONNA K DEMPSEY ARNP PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1982889341
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/20/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 55942
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT PETERSBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33732-5942
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-914-9188
Provider Business Mailing Address Fax Number:
727-954-4912

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2931 1ST AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33712-1008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-914-9188
Provider Business Practice Location Address Fax Number:
727-954-4912
Provider Enumeration Date:
01/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DEMPSEY
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
KAY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
727-914-9188

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 300280200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: Y7128 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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