Provider Demographics
NPI:1902895394
Name:HEMPHILL, DEBRA LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 GULF BREEZE PKWY
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3091
Mailing Address - Country:US
Mailing Address - Phone:850-934-5713
Mailing Address - Fax:
Practice Address - Street 1:2744 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-3091
Practice Address - Country:US
Practice Address - Phone:850-934-5713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2069712363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY017EOtherBCBSFL
FL303386400Medicaid
FLE5523YMedicare ID - Type Unspecified
FLY017EOtherBCBSFL