Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 840993 | TX |
NPI | 1366117145 |
---|---|
Provider Name | Jessica Hernandez |
First Address | Corpus Christi, TX 78411-1721 |
Second Address | Harlingen, TX 78550-8307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2021 |
Last Update Date | 12/08/2021 |