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General NPI Number Information
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NPI Number | 1497551121
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Entity Type | Individual
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Provider Name | AMANDA HERNANDEZ RN, CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 22 S GREENE ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1544
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Country | US
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Telephone | 410-328-0958
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Fax |
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Provider Business Mailing Address
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Address Line | 13939 MANTUA MILL RD
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City | GLYNDON
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State | MD
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Zip | 21136-4834
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Country | US
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Telephone | 484-889-6477
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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 | R228228
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License Number State | MD
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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 | SP032501
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License Number State | PA
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