Provider Demographics
NPI:1194275271
Name:HEBERT, DANIELLE N (APRN-C)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:N
Last Name:HEBERT
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 W SWANN AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2417
Mailing Address - Country:US
Mailing Address - Phone:813-254-8055
Mailing Address - Fax:813-443-8163
Practice Address - Street 1:1919 W SWANN AVE FL 3
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2417
Practice Address - Country:US
Practice Address - Phone:813-254-8055
Practice Address - Fax:813-443-8163
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9358574363LF0000X, 363LP2300X
FLAPRN9358594363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103350400Medicaid