Healthcare Provider Details

I. General information

NPI: 1407725849
Provider Name (Legal Business Name): STEPHANIE M. HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N HIGLEY RD
GILBERT AZ
85234-1604
US

IV. Provider business mailing address

1900 N HIGLEY RD
GILBERT AZ
85234-1604
US

V. Phone/Fax

Practice location:
  • Phone: 480-332-4493
  • Fax:
Mailing address:
  • Phone: 480-332-4493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN127971
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: