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General NPI Number Information
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NPI Number | 1659194785
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Entity Type | Individual
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Provider Name | KIEU HERNANDEZ AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 1200 NE 48TH AVE STE 1100
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City | HILLSBORO
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State | OR
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Zip | 97124-5062
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Country | US
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Telephone | 503-494-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 2140 S IVY ST
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City | CORNELIUS
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State | OR
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Zip | 97113-7359
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Country | US
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Telephone | 832-589-2530
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10034954
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License Number State | OR
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