Provider Demographics
NPI:1093322539
Name:HERNANDEZ, VANESSA (RN)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:CESAR-MUNOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 HARDY AVE
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-1932
Mailing Address - Country:US
Mailing Address - Phone:903-229-3740
Mailing Address - Fax:
Practice Address - Street 1:210 HARDY AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-1932
Practice Address - Country:US
Practice Address - Phone:903-229-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001627163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse