Provider Demographics
NPI:1124410972
Name:HEBERT, MIRANDA LEIGH (DNP, APRN)
Entity type:Individual
Prefix:DR
First Name:MIRANDA
Middle Name:LEIGH
Last Name:HEBERT
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:DR
Other - First Name:MIRANDA
Other - Middle Name:LEIGH
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, CNM
Mailing Address - Street 1:10129 CROSSING WAY STE D-404
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-5891
Mailing Address - Country:US
Mailing Address - Phone:225-283-1211
Mailing Address - Fax:225-283-1217
Practice Address - Street 1:10129 CROSSING WAY STE D-404
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-5891
Practice Address - Country:US
Practice Address - Phone:225-283-1211
Practice Address - Fax:225-283-1217
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARM002129367A00000X
IL277.000505367A00000X
LAAP07660367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife