Provider Demographics
NPI:1770550675
Name:KEMP, HEATHER PARR (CRNA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:PARR
Last Name:KEMP
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:COURTNEY
Other - Last Name:PARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:4901 GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8965
Mailing Address - Country:US
Mailing Address - Phone:850-477-7042
Mailing Address - Fax:850-477-7042
Practice Address - Street 1:4901 GRANDE DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8965
Practice Address - Country:US
Practice Address - Phone:850-477-7042
Practice Address - Fax:850-477-7042
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9169717367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG395OtherBLUE CROSS BLUE SHIELD
P00314665OtherMEDICARE RAILROAD
AL591-85013OtherBLUE CROSS BLUE SHIELD
AL009936606Medicaid
FL307538900Medicaid
FL307538900Medicaid