Provider Demographics
NPI:1447229232
Name:HEBERT, LAUREEN MARIE (CNM, FNP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREEN
Middle Name:MARIE
Last Name:HEBERT
Suffix:
Gender:F
Credentials:CNM, FNP
Other - Prefix:
Other - First Name:LARUEEN
Other - Middle Name:MARIE
Other - Last Name:DEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM, FNP
Mailing Address - Street 1:KAISER PERMANENTE SAN MARCOS MEDICAL OFFICES OBGYN
Mailing Address - Street 2:400 CRAVEN ROAD
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078
Mailing Address - Country:US
Mailing Address - Phone:760-510-4046
Mailing Address - Fax:760-510-4142
Practice Address - Street 1:KAISER PERMANENTE SAN MARCOS MEDICAL OFFICES OBGYN
Practice Address - Street 2:400 CRAVEN ROAD
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078
Practice Address - Country:US
Practice Address - Phone:760-510-4046
Practice Address - Fax:760-510-4142
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW959367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife