MEDICARE: BRIANNA LEE HERNANDEZ MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367H00000X	Anesthesiologist Assistant

General Provider Information

NPI Number	:	1053262915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA LEE HERNANDEZ MS

Provider Business Mailing Address
First Line	:	1402 COLUMBIA CIR
Second Line	:
City	:	INDIAN LAND
State	:	SC
Zip	:	29707-7972
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 HERLONG AVE S
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-1158
Country	:	US
Telephone Number	:	803-329-6711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	05/01/2026

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