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General NPI Number Information
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NPI Number | 1770950099
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Entity Type | Individual
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Provider Name | PHILIP HERNANDEZ APRN, CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 240 OLD COHAS AVE
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City | MANCHESTER
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State | NH
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Zip | 03109-4839
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Country | US
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Telephone | 603-203-1350
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Fax |
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Provider Business Mailing Address
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Address Line | 240 OLD COHAS AVE
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City | MANCHESTER
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State | NH
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Zip | 03109-4839
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RE2128
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License Number State | GU
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | NP0155
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License Number State | GU
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 705919
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License Number State | NY
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