Provider Demographics
NPI:1093058448
Name:HERNANDEZ, MICHELLE BETH (CPM)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:BETH
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6459
Mailing Address - Country:US
Mailing Address - Phone:405-447-9433
Mailing Address - Fax:405-447-9433
Practice Address - Street 1:2121 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6459
Practice Address - Country:US
Practice Address - Phone:405-447-9433
Practice Address - Fax:405-447-9433
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife