Provider Demographics
NPI:1598855975
Name:HEBERT, JODIE ANN (RN/RCS)
Entity Type:Individual
Prefix:MRS
First Name:JODIE
Middle Name:ANN
Last Name:HEBERT
Suffix:
Gender:F
Credentials:RN/RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68390 SAJDAK RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-2668
Mailing Address - Country:US
Mailing Address - Phone:715-682-2904
Mailing Address - Fax:
Practice Address - Street 1:68390 SAJDAK RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-2668
Practice Address - Country:US
Practice Address - Phone:715-682-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health