Provider Demographics
NPI:1861011082
Name:BEMPAH, JOSHUA (CRNA)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:BEMPAH
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 1:104 FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-6248
Mailing Address - Country:US
Mailing Address - Phone:704-692-3852
Mailing Address - Fax:
Practice Address - Street 1:104 FOREST CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-6248
Practice Address - Country:US
Practice Address - Phone:704-692-3852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN291181163W00000X
NC006867367500000X
TX1084058367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse