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General NPI Number Information
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NPI Number | 1841492600
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Entity Type | Individual
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Provider Name | ELAINE HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | BROOKE ARMY MEDICAL CENTER 3551 ROGER BROOKE ROAD
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-916-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 106 NEAL AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78214-1234
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Country | US
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Telephone | 608-381-5718
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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 | 1325-033
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License Number State | WI
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