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NPI Code Detail

MEDICARE: DORA MARICELA HERNANDEZ-STEWART NP

MEDICARE:   DORA MARICELA HERNANDEZ-STEWART  NP
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
1363LF0000XFamily Nurse PractitionerCNP00524NM

General Provider Information

NPI Number : 1114364932
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORA MARICELA HERNANDEZ-STEWART NP
Provider Business Mailing Address
First Line : 517 N PARK DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-3891
Country : US
Telephone Number : 575-528-5180
Fax Number :
Provider Business Practice Location Address
First Line : 1170 N SOLANO DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88001-2371
Country : US
Telephone Number : 575-528-5180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2013
Last Update Date : 06/03/2013

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Directions to “ DORA MARICELA HERNANDEZ-STEWART NP” Practice Location

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