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NPI Code Detail

MEDICARE: JESSICA HERNANDEZ

MEDICARE:   JESSICA  HERNANDEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse353740TX

General Provider Information

NPI Number : 1568070878
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA HERNANDEZ
Provider Business Mailing Address
First Line : 4232 LOMA TAURINA DR
Second Line :
City : EL PASO
State : TX
Zip : 79934-3704
Country : US
Telephone Number : 360-471-5011
Fax Number :
Provider Business Practice Location Address
First Line : 4232 LOMA TAURINA DR
Second Line :
City : EL PASO
State : TX
Zip : 79934-3704
Country : US
Telephone Number : 360-471-5011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2020
Last Update Date : 07/22/2020

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Directions to “ JESSICA HERNANDEZ ” Practice Location

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