Provider Demographics
NPI:1114202058
Name:HERNANDEZ, EUNJU YANG (CRNP-FAMILY)
Entity Type:Individual
Prefix:MRS
First Name:EUNJU
Middle Name:YANG
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:CRNP-FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11800 SUNSET HILLS RD
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-4776
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:46165 WESTLAKE DR., SUITE 120
Practice Address - Street 2:
Practice Address - City:POTOMAC FALLS
Practice Address - State:VA
Practice Address - Zip Code:20165-5872
Practice Address - Country:US
Practice Address - Phone:703-444-3302
Practice Address - Fax:703-444-3240
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169510363LF0000X
FL9466599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily