Provider Demographics
NPI:1407516735
Name:HERNANDEZ, NORMA LORENA (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:LORENA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16501 PORTAGE ST
Mailing Address - Street 2:
Mailing Address - City:JUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:76247-1069
Mailing Address - Country:US
Mailing Address - Phone:580-656-5482
Mailing Address - Fax:
Practice Address - Street 1:3614 CAMP BOWIE BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-3352
Practice Address - Country:US
Practice Address - Phone:817-870-1873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1093787363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily