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NPI Code Detail

MEDICARE: SELYN ELISE HERNANDEZ

MEDICARE: SELYN ELISE 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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1750745303
Entity Type Code : Individual
Provider Name (Legal Business Name) : SELYN ELISE HERNANDEZ
Provider Business Mailing Address
First Line : 1512 MONACO PKWY
Second Line :
City : DENVER
State : CO
Zip : 80220-1641
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1512 MONACO PKWY
Second Line :
City : DENVER
State : CO
Zip : 80220-1641
Country : US
Telephone Number : 303-504-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2016
Last Update Date : 04/11/2016

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Directions to “ SELYN ELISE HERNANDEZ ” Practice Location

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