Provider Demographics
NPI:1013593359
Name:HEBRON, STEPHANIE SCHIMSCHOCK (RN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SCHIMSCHOCK
Last Name:HEBRON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 RIVERSIDE LN
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:LA
Mailing Address - Zip Code:71456-3431
Mailing Address - Country:US
Mailing Address - Phone:318-349-9910
Mailing Address - Fax:
Practice Address - Street 1:537 CUMBERLAND DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-5919
Practice Address - Country:US
Practice Address - Phone:318-560-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN126694163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics