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General NPI Number Information
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NPI Number | 1295338978
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Entity Type | Individual
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Provider Name | CARRIE LIN HERNANDEZ APRN-C
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Gender | Female
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 4221 RIDGECREST RD STE 107
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City | GREENVILLE
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State | TX
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Zip | 75402-6015
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Country | US
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Telephone | 903-454-9976
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Fax |
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Provider Business Mailing Address
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Address Line | 4055 VALLEY VIEW LN STE 700
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City | DALLAS
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State | TX
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Zip | 75244-5045
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Country | US
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Telephone | 972-715-3800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-79817-091
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1074272
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License Number State | TX
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