Provider Demographics
NPI:1366527822
Name:HESPELER, LUANNE C (PA-C)
Entity type:Individual
Prefix:
First Name:LUANNE
Middle Name:C
Last Name:HESPELER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 CONCOURSE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-1033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:410-883-0876
Practice Address - Street 1:3950 3RD ST N STE A
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-6123
Practice Address - Country:US
Practice Address - Phone:727-821-0612
Practice Address - Fax:727-822-5507
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06015363A00000X
CT000177363A00000X
FLPA9115234363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
970027627OtherRAILROAD MEDICARE
970027627OtherRAILROAD MEDICARE