Dedra Hern Crna LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP2702392 Issued in FL

Legal business name

DEDRA HERN CRNA LLC

Practice address

1601 38TH Ave N
St Petersburg, FL 33713-1926

Phone

(317) 614-9863

Fax

(844) 876-0873

NPI assigned

Dec 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dedra Hern, CRNA

Title

President

Phone

(813) 215-4960

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1679635924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001 DEPT 0451",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850451",
            "telephone_number": "855-543-5604",
            "fax_number": "855-679-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 38TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337131926",
            "telephone_number": "317-614-9863",
            "fax_number": "844-876-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDRA HERN CRNA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "HERN",
        "authorized_official_first_name": "DEDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-215-4960",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP2702392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC1392",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE CROSS",
            "identifier": "G9055",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306290200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Decker
• John B Decosmo, DO
• Dedicated Senior Medical Center St. Petersburg, LLC.
• Dedicated Senior Medical Centers of Florida, LLC
• Dedicated Senior Medical Centers of Florida, LLC
• Samantha Dedrick
• Megan Deedrich, FNP-BC
• Savannah Nicole Deering, RD
• Ivy Defelix, RN
• Stella M Defortuna, MD

• Certified Registered Nurse Anesthetist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.