Healthcare Provider Details

I. General information

NPI: 1427532308
Provider Name (Legal Business Name): JARYSBEL HERNANDEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 149 KM 7.5 BO RIO ARRIBA SALIENTE
MANATI PR
00674
US

IV. Provider business mailing address

CARR 149 KM 7.5 BO RIO ARRIBA SALIENTE
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-238-4471
  • Fax: 787-884-5704
Mailing address:
  • Phone: 787-238-4471
  • Fax: 787-884-5704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number030388
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: