Healthcare Provider Details

I. General information

NPI: 1164876264
Provider Name (Legal Business Name): FRANCESCA MY HERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2016
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 G ST
SPRINGFIELD OR
97477-4112
US

IV. Provider business mailing address

1460 G ST
SPRINGFIELD OR
97477-4112
US

V. Phone/Fax

Practice location:
  • Phone: 541-726-4400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD194290
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA153440
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: