Provider Demographics
NPI:1679784185
Name:HERFERT, LOU ANN TABOR (RNC, CNNP)
Entity type:Individual
Prefix:MRS
First Name:LOU ANN
Middle Name:TABOR
Last Name:HERFERT
Suffix:
Gender:F
Credentials:RNC, CNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2876 WAKEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-2935
Mailing Address - Country:US
Mailing Address - Phone:650-497-8800
Mailing Address - Fax:650-497-8035
Practice Address - Street 1:725 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1601
Practice Address - Country:US
Practice Address - Phone:650-497-8800
Practice Address - Fax:650-497-8034
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8984363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal