Healthcare Provider Details

I. General information

NPI: 1457095523
Provider Name (Legal Business Name): ANNETTE ELIZABETH HEBERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 TULANE AVE # 8679
NEW ORLEANS LA
70112-2632
US

IV. Provider business mailing address

1430 TULANE AVE # 8679
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-2436
  • Fax: 504-988-2799
Mailing address:
  • Phone: 504-988-2436
  • Fax: 504-988-2799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number349538
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: