Individual
MRS. ANDREA NICOLE HEBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306
Mailing address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110002647
VA
363AS0400X
Surgical Physician Assistant
Primary
0110002647
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063601607
ANTHEM MEDIGAP
VA
01
—
540506332115
TRICARE/CHAMPUS
VA
01
—
P00834686
RAILROAD MEDICARE
VA
Enumeration date
10/19/2007
Last updated
12/10/2020
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