Provider Demographics
NPI:1467013946
Name:HEBERT, JAMIE L (EI SPECIALIST)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:HEBERT
Suffix:
Gender:F
Credentials:EI SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-3813
Mailing Address - Country:US
Mailing Address - Phone:860-218-0309
Mailing Address - Fax:
Practice Address - Street 1:27 FLORENCE ST
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-3813
Practice Address - Country:US
Practice Address - Phone:860-218-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program