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NPI Code Detail

MEDICARE: BLANCA HERNANDEZ LMSW

MEDICARE:   BLANCA  HERNANDEZ  LMSW
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
1104100000XSocial WorkerM-09689NM

General Provider Information

NPI Number : 1417409582
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLANCA HERNANDEZ LMSW
Provider Business Mailing Address
First Line : 1223 PLAIN ST
Second Line :
City : LAS CRUCES
State : NM
Zip : 88001-5634
Country : US
Telephone Number : 575-650-7028
Fax Number :
Provider Business Practice Location Address
First Line : 2805 LAS VEGAS CT STE B
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-4108
Country : US
Telephone Number : 575-522-5144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2016
Last Update Date : 10/25/2016

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Directions to “ BLANCA HERNANDEZ LMSW” Practice Location

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