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General NPI Number Information
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NPI Number | 1528545621
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Entity Type | Individual
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Provider Name | ALICIA HERNANDEZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 4506 BRIARWOOD AVE
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City | MIDLAND
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State | TX
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Zip | 79707-2642
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Country | US
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Telephone | 432-689-6818
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Fax | 432-689-6901
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Provider Business Mailing Address
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Address Line | PO BOX 1385
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City | STANTON
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State | TX
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Zip | 79782-1385
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Country | US
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Telephone | 432-268-3618
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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 | 138138
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License Number State | TX
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