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General NPI Number Information
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NPI Number | 1922912609
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Entity Type | Individual
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Provider Name | ANGELICA HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 110 WOOD LN
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City | RUIDOSO DOWNS
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State | NM
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Zip | 88346-5040
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Country | US
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Telephone | 575-260-1808
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Fax |
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Provider Business Mailing Address
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Address Line | 104 ASPEN DR SPC 19
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City | CAPITAN
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State | NM
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Zip | 88316-5105
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Country | US
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Telephone | 316-992-9828
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | NM
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