Individual
MARY LAURENCE HEBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
HWY 160/163 BLDG KA2010, KAYENTA, AZ 86033-0368
(928) 697-4000
Mailing address
1156 BOWMAN CTST100A, MT. PLEASANT, SC 29464
(888) 686-6877
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN097404
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN097404
LICENSE
LA
Enumeration date
02/18/2014
Last updated
02/18/2014
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