Provider Demographics
NPI:1548783756
Name:TEMPEST, HEATHER R (APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:TEMPEST
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:KENNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:407 WEKIVA SPRINGS RD STE 123
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-6157
Mailing Address - Country:US
Mailing Address - Phone:407-790-7998
Mailing Address - Fax:877-830-8517
Practice Address - Street 1:407 WEKIVA SPRINGS RD STE 123
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-6157
Practice Address - Country:US
Practice Address - Phone:407-790-7998
Practice Address - Fax:877-830-8517
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN539064163W00000X
PASP017779363LF0000X
FL11005743363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105471000Medicaid