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General NPI Number Information
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NPI Number | 1972326759
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Entity Type | Individual
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Provider Name | MONICA HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 1700 CARGO CT
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City | LOUISVILLE
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State | KY
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Zip | 40299-1938
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Country | US
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Telephone | 866-850-6585
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Fax |
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Provider Business Mailing Address
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Address Line | 8819 WISDOM LN
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City | LOUISVILLE
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State | KY
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Zip | 40229-2583
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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 | 1174082
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License Number State | KY
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