Provider Demographics
NPI:1083194096
Name:HEBERT, KAITLIN LOUPE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:LOUPE
Last Name:HEBERT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:ANNE
Other - Last Name:LOUPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13536 STONELAKE DR
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:LA
Mailing Address - Zip Code:70437-3246
Mailing Address - Country:US
Mailing Address - Phone:504-284-8563
Mailing Address - Fax:
Practice Address - Street 1:29148 S MONTPELIER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:LA
Practice Address - Zip Code:70711-4320
Practice Address - Country:US
Practice Address - Phone:225-209-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-19
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022622183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist