Healthcare Provider Details

I. General information

NPI: 1922636216
Provider Name (Legal Business Name): NATALIE MARIE HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2870 PEACHTREE RD NW # 894
ATLANTA GA
30305-2918
US

IV. Provider business mailing address

2870 PEACHTREE RD NW # 894
ATLANTA GA
30305-2918
US

V. Phone/Fax

Practice location:
  • Phone: 855-606-5433
  • Fax: 833-664-1782
Mailing address:
  • Phone: 855-606-5433
  • Fax: 833-664-1782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberW5370
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberW5370
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: