Doctor Name: | MR. JEFFREY H HERNANDEZ |
NPI Number: | 1730565789 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-BC |
License Number: | 20010 |
Business Practice Address: | 106 S Military St Loretto, TN - 384692100 |
Business Phone Number: | 9318534622 |
Business Fax Number: | |
Mailing Address: | 106 S Military St, LORETTO |
State: | TN |
Postal Code: | 384692100 |
Phone Number: | 9318534622 |
Fax Number: | |
NPI Enumeration Date: | 07/31/2015 |
NPI Last Update Date: | 09/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 20010 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |