Provider Demographics
NPI:1770968059
Name:HEBB, BRANDIE LEA
Entity type:Individual
Prefix:
First Name:BRANDIE
Middle Name:LEA
Last Name:HEBB
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 1:232 BUTTERNUT LN
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-1358
Mailing Address - Country:US
Mailing Address - Phone:440-292-6929
Mailing Address - Fax:
Practice Address - Street 1:232 BUTTERNUT LN
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-1358
Practice Address - Country:US
Practice Address - Phone:440-292-6929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.17490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily