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NPI Code Detail

MEDICARE: CHANCE HERNANDEZ

MEDICARE: CHANCE HERNANDEZ
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 Practitioner228956OK

General Provider Information

NPI Number : 1649102484
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANCE HERNANDEZ
Provider Business Mailing Address
First Line : 5472 MAIN ST STE 101
Second Line :
City : DEL CITY
State : OK
Zip : 73115-5524
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5472 MAIN ST STE 101
Second Line :
City : DEL CITY
State : OK
Zip : 73115-5524
Country : US
Telephone Number : 405-622-3699
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ CHANCE HERNANDEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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