Healthcare Provider Details

I. General information

NPI: 1285033308
Provider Name (Legal Business Name): BRIEANA ELAINE HERNANDEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 N IH 35 SUITE 700
AUSTIN TX
78705-1804
US

IV. Provider business mailing address

3000 N IH 35 SUITE 700
AUSTIN TX
78705-1804
US

V. Phone/Fax

Practice location:
  • Phone: 512-807-3150
  • Fax: 512-458-7879
Mailing address:
  • Phone: 512-807-3150
  • Fax: 512-458-7879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberAP125966
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberAP125966
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: