Healthcare Provider Details

I. General information

NPI: 1548622251
Provider Name (Legal Business Name): JOANNA HERNANDEZ DNP, RN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANNA TURNER DNP, RN, AGACNP-BC

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28573 SCHOENHERR RD
WARREN MI
48088-4330
US

IV. Provider business mailing address

39349 CADBOROUGH DR
CLINTON TOWNSHIP MI
48038-2748
US

V. Phone/Fax

Practice location:
  • Phone: 586-777-3375
  • Fax: 586-777-3380
Mailing address:
  • Phone: 248-561-0693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704270939
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704270939
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704270939
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: