Provider Demographics
NPI:1508182593
Name:HEMBD, GARY BENJAMIN (CRNA)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:BENJAMIN
Last Name:HEMBD
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E HOLME ST
Mailing Address - Street 2:PO BOX 250
Mailing Address - City:NORTON
Mailing Address - State:KS
Mailing Address - Zip Code:67654-1406
Mailing Address - Country:US
Mailing Address - Phone:785-877-3351
Mailing Address - Fax:
Practice Address - Street 1:102 E HOLME ST
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:KS
Practice Address - Zip Code:67654-1406
Practice Address - Country:US
Practice Address - Phone:785-877-3351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS140551367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered