Provider Demographics
NPI:1407345978
Name:HEBERT, REBECCA LYNN (CNM)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:HEBERT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-2122
Mailing Address - Country:US
Mailing Address - Phone:508-295-5197
Mailing Address - Fax:508-291-6375
Practice Address - Street 1:106 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-2122
Practice Address - Country:US
Practice Address - Phone:508-295-5197
Practice Address - Fax:508-291-6375
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2277079367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty