=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366527822
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUANNE C HESPELER PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2006
-----------------------------------------------------
Last Update Date | 08/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3950 3RD ST N STE A
-----------------------------------------------------
City | ST PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33703-6123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-821-0612
-----------------------------------------------------
Fax | 727-822-5507
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1167 RANCHWOOD DR E
-----------------------------------------------------
City | DUNEDIN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34698-5527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-912-3202
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 0010-06015
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 000177
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | PA9115234
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------