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NPI Code Detail

MEDICARE: TRACIE NICOLE JAY-HERNANDEZ APRN, FNP-C

MEDICARE: TRACIE NICOLE JAY-HERNANDEZ APRN, FNP-C
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
1363LF0000XFamily Nurse Practitioner1182600TX

General Provider Information

NPI Number : 1720549355
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACIE NICOLE JAY-HERNANDEZ APRN, FNP-C
Provider Business Mailing Address
First Line : 17754 PRESTON RD STE 100
Second Line :
City : DALLAS
State : TX
Zip : 75252-5638
Country : US
Telephone Number : 214-557-3289
Fax Number :
Provider Business Practice Location Address
First Line : 17754 PRESTON RD STE 100
Second Line :
City : DALLAS
State : TX
Zip : 75252-5638
Country : US
Telephone Number : 214-557-3289
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2019
Last Update Date : 05/08/2026

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Directions to “ TRACIE NICOLE JAY-HERNANDEZ APRN, FNP-C” Practice Location

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