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NPI Code Detail

MEDICARE: MRS. AUDREY KATHERINE HEBERT RN, MSN, FNP

MEDICARE: MRS. AUDREY KATHERINE HEBERT RN, MSN, FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN 63583-030WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346236783
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AUDREY KATHERINE HEBERT RN, MSN, FNP
Provider Business Mailing Address
First Line : 6015 S ABERDEEN DR
Second Line :
City : NEW BERLIN
State : WI
Zip : 53146-5204
Country : US
Telephone Number : 262-679-1984
Fax Number : 414-765-0226
Provider Business Practice Location Address
First Line : 1027 N 9TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53233-1411
Country : US
Telephone Number : 414-765-0606
Fax Number : 414-765-0226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 07/09/2007

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