Healthcare Provider Details

I. General information

NPI: 1942442090
Provider Name (Legal Business Name): CARMEN MARIA HERNANDEZ CARMEN HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARMEN JANECK MSN, NNP-BC

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 01/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 E 19TH AVE
DENVER CO
80218-1235
US

IV. Provider business mailing address

5392 S HOLLAND ST
LITTLETON CO
80123-7433
US

V. Phone/Fax

Practice location:
  • Phone: 303-839-7390
  • Fax:
Mailing address:
  • Phone: 303-257-7452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number109420
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: