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General NPI Number Information
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NPI Number | 1386068971
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Entity Type | Individual
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Provider Name | MARY LAURENCE HEBERT R.N.
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Gender | Female
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | HWY 160/163 BLDG KA2010
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City | KAYENTA
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State | AZ
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Zip | 86033-0368
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Country | US
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Telephone | 928-697-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1156 BOWMAN CTST100A
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City | MT. PLEASANT
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State | SC
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Zip | 29464
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Country | US
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Telephone | 888-686-6877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN097404
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License Number State | LA
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