Provider Demographics
NPI:1033721154
Name:HEART RESCUE CPR LLC
Entity Type:Organization
Organization Name:HEART RESCUE CPR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DESHAYNA
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, FNP-C
Authorized Official - Phone:859-536-9686
Mailing Address - Street 1:501 DARBY CREEK RD STE 18
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1606
Mailing Address - Country:US
Mailing Address - Phone:859-687-4713
Mailing Address - Fax:
Practice Address - Street 1:501 DARBY CREEK RD STE 18
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1606
Practice Address - Country:US
Practice Address - Phone:859-687-4713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty