Provider Demographics
NPI:1073989224
Name:HEBERT, KRISTY (NP)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:HEBERT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4275 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:LA
Mailing Address - Zip Code:70359-6410
Mailing Address - Country:US
Mailing Address - Phone:985-360-3781
Mailing Address - Fax:985-360-3782
Practice Address - Street 1:4275 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:LA
Practice Address - Zip Code:70359-6410
Practice Address - Country:US
Practice Address - Phone:985-360-3781
Practice Address - Fax:985-360-3782
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08283363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily