Provider Demographics
NPI:1477554392
Name:HEBEL, JEANETTE LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:LOUISE
Last Name:HEBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1650 CROOKED OAK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4274
Mailing Address - Country:US
Mailing Address - Phone:717-569-3279
Mailing Address - Fax:717-509-5297
Practice Address - Street 1:1650 CROOKED OAK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4274
Practice Address - Country:US
Practice Address - Phone:717-569-3279
Practice Address - Fax:717-509-5297
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427616207ND0101X, 207ND0101X
NC200200736207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA097751DW4Medicare PIN