Hern, Dedra

Hern, Dedra is an individual health care provider with primary practice located at 1601 38Th Ave N , St Petersburg FL 33713-1926. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Hern, Dedra can be contacted via phone (317) 614-9863.

Contact Information

Primary practice address
1601 38Th Ave N St Petersburg FL 33713-1926
Phone: (317) 614-9863
Fax: (844) 876-0873
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP2702392 Florida

Profile Details

NPI number 1912946575
LBN Legal business name Hern, Dedra
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Feb 16th, 2017 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1912946575 NPPES
Florida MEDICAID 302936100

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