Individual
AMANDA J. HEBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO
Contact information
Practice address
1931 J N PEASE PL STE 104, CHARLOTTE, NC 28262-4540
(704) 510-2204
Mailing address
1931 J N PEASE PL STE 104, CHARLOTTE, NC 28262-4540
(704) 721-6840
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047KU
BCBS
NC
05
—
7704797
—
NC
Enumeration date
01/02/2008
Last updated
03/04/2010
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