Healthcare Provider Details

I. General information

NPI: 1962693374
Provider Name (Legal Business Name): LORI FERREBEE HEBERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI BETH FERREBEE PA-C

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8166 MAIN ST
HOUMA LA
70360-3404
US

IV. Provider business mailing address

8166 MAIN ST.
HOUMA LA
70360-3404
US

V. Phone/Fax

Practice location:
  • Phone: 800-456-9121
  • Fax:
Mailing address:
  • Phone: 985-873-4247
  • Fax: 985-873-3772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTEMP
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code364SE0003X
TaxonomyEmergency Clinical Nurse Specialist
License NumberPA.200.152.RX
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: