Healthcare Provider Details

I. General information

NPI: 1871222430
Provider Name (Legal Business Name): ELISABETH MEEHNA HERNANDEZ MSN RN APRN-CNS CCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELISABETH MEEHNA HERNANDEZ-GREENBERG MSN, RN APRN-CNS CCM

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 06/22/2024
Certification Date: 06/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 WILLAGILLESPIE RD STE A
EUGENE OR
97401-2106
US

IV. Provider business mailing address

935 WILLAGILLESPIE RD STE A
EUGENE OR
97401-2106
US

V. Phone/Fax

Practice location:
  • Phone: 541-600-0878
  • Fax: 541-854-4000
Mailing address:
  • Phone: 708-666-0030
  • Fax: 541-854-4000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0121X
TaxonomyPlastic Surgery Registered Nurse
License Number201406369RN
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number201406369RN
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number202213113CNS-PP
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number202213113CNS-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: