Healthcare Provider Details

I. General information

NPI: 1467220251
Provider Name (Legal Business Name): DENICE HERNANDEZ APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 OVERLOOK RD STE 140
SUMMIT NJ
07901-3577
US

IV. Provider business mailing address

PO BOX 95000 LB#75000
PHILADELPHIA PA
19195-3577
US

V. Phone/Fax

Practice location:
  • Phone: 908-277-0050
  • Fax:
Mailing address:
  • Phone: 844-362-1735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ14958600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ14958600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: