Basic Information
| Provider Information | |||||||||
| NPI: | 1407029408 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HIEBERT | ||||||||
| FirstName: | SHYLA | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8325 KELWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708064804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2259297600 | ||||||||
| FaxNumber: | 2259307524 | ||||||||
| Practice Location | |||||||||
| Address1: | 8325 KELWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708064804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2259297600 | ||||||||
| FaxNumber: | 2259307524 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2008 | ||||||||
| LastUpdateDate: | 04/10/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN110258 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.