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General NPI Number Information
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NPI Number | 1568019826
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Entity Type | Individual
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Provider Name | MICHELLE RENEE HERNANDEZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/21/2019
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 115 MALL DR
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City | HANFORD
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State | CA
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Zip | 93230-5786
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Country | US
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Telephone | 559-537-1160
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Fax | 559-537-1169
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Provider Business Mailing Address
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Address Line | 1588 LINDEN ST
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City | LEMOORE
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State | CA
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Zip | 93245-5291
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Country | US
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Telephone | 559-816-3914
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CA
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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 | 95013329
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License Number State | CA
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