Healthcare Provider Details

I. General information

NPI: 1619368784
Provider Name (Legal Business Name): ERIN HERNANDEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 05/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 NW EXPRESSWAY
OKLAHOMA CITY OK
73112
US

IV. Provider business mailing address

3300 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-4418
US

V. Phone/Fax

Practice location:
  • Phone: 405-949-3393
  • Fax: 405-949-6977
Mailing address:
  • Phone: 405-949-3393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number92119
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: