Provider Demographics
NPI:1740508316
Name:HEBERT, JOHNICA ANN (FNP, ANP)
Entity type:Individual
Prefix:MS
First Name:JOHNICA
Middle Name:ANN
Last Name:HEBERT
Suffix:
Gender:F
Credentials:FNP, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 KALISTE SALOOM RD
Mailing Address - Street 2:STE 122
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-4230
Mailing Address - Country:US
Mailing Address - Phone:337-235-9355
Mailing Address - Fax:337-235-9356
Practice Address - Street 1:850 KALISTE SALOOM RD STE 122
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4230
Practice Address - Country:US
Practice Address - Phone:337-235-9355
Practice Address - Fax:337-235-9356
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN115555-AP06066363LA2200X
LAAP06066363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health