Provider Demographics
NPI:1477927689
Name:HEBERT, ALANNA DENISE
Entity Type:Individual
Prefix:MRS
First Name:ALANNA
Middle Name:DENISE
Last Name:HEBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 MAMOU PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:BASILE
Mailing Address - State:LA
Mailing Address - Zip Code:70515-3939
Mailing Address - Country:US
Mailing Address - Phone:337-580-0930
Mailing Address - Fax:
Practice Address - Street 1:1366 MAMOU PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:BASILE
Practice Address - State:LA
Practice Address - Zip Code:70515-3939
Practice Address - Country:US
Practice Address - Phone:337-580-0930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-26
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08584363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAP08584Medicare UPIN