Provider Demographics
NPI:1720171556
Name:HESS, JOHN E (ARNP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:HESS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N MALACATE ST
Mailing Address - Street 2:
Mailing Address - City:AJO
Mailing Address - State:AZ
Mailing Address - Zip Code:85321-2254
Mailing Address - Country:US
Mailing Address - Phone:520-387-5651
Mailing Address - Fax:520-387-6036
Practice Address - Street 1:410 N MALACATE ST
Practice Address - Street 2:
Practice Address - City:AJO
Practice Address - State:AZ
Practice Address - Zip Code:85321
Practice Address - Country:US
Practice Address - Phone:520-387-5651
Practice Address - Fax:520-387-6036
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9206510363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1720171556OtherNPI
FLA0806308OtherNP-C
FLSSNOtherTRICARE
366988OtherHEALTHEASE/HEALTHYKIDS
FL307964300Medicaid
FLARNP9206510OtherLICENSE NUMBER