Healthcare Provider Details

I. General information

NPI: 1124410972
Provider Name (Legal Business Name): MIRANDA LEIGH HEBERT DNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MIRANDA LEIGH BROWN DNP, CNM

II. Dates (important events)

Enumeration Date: 03/03/2015
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10129 CROSSING WAY STE D-404
DENHAM SPRINGS LA
70726-5891
US

IV. Provider business mailing address

10129 CROSSING WAY STE D-404
DENHAM SPRINGS LA
70726-5891
US

V. Phone/Fax

Practice location:
  • Phone: 225-283-1211
  • Fax: 225-283-1217
Mailing address:
  • Phone: 225-283-1211
  • Fax: 225-283-1217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberM002129
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number277.000505
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP07660
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: