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General NPI Number Information
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NPI Number | 1376601641
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Entity Type | Individual
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Provider Name | ELIZABETH LORENA HERNANDEZ CASE MANAGEMENT
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 4185 SUMMIT GATE DR
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City | SUWANEE
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State | GA
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Zip | 30024-6491
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Country | US
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Telephone | 404-578-1843
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Fax | 678-714-1753
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Provider Business Mailing Address
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Address Line | 4185 SUMMIT GATE DR
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City | SUWANEE
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State | GA
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Zip | 30024-6491
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Country | US
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Telephone | 404-578-1843
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Fax | 678-714-1753
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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