Provider Demographics
NPI:1265644801
Name:HEBENSTREIT, SANDRA (NP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:HEBENSTREIT
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 1:255 COMMUNICATIONS WAY
Mailing Address - Street 2:MACC-REVENUE CYCLE
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1866
Mailing Address - Country:US
Mailing Address - Phone:508-957-8664
Mailing Address - Fax:508-957-8677
Practice Address - Street 1:150 ANSEL HALLET ROAD
Practice Address - Street 2:
Practice Address - City:WEST YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673
Practice Address - Country:US
Practice Address - Phone:508-771-8350
Practice Address - Fax:508-771-8060
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA177474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily