| Doctor Name: | JESUS HERNANDEZ |
| NPI Number: | 1730400870 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CNP |
| License Number: | CNP-01621 |
| Business Practice Address: | 510 E Lisa Dr Chaparral, NM - 880817809 |
| Business Phone Number: | 5758240820 |
| Business Fax Number: | 5758241021 |
| Mailing Address: | 385 Calle De Alegra, Bldg. A LAS CRUCES |
| State: | NM |
| Postal Code: | 880053417 |
| Phone Number: | 5755261105 |
| Fax Number: | 5755244266 |
| NPI Enumeration Date: | 06/11/2010 |
| NPI Last Update Date: | 02/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | CNP-01621 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |