Provider Demographics
NPI:1407540818
Name:HERNANDEZ, DEYSI (L)
Entity Type:Individual
Prefix:
First Name:DEYSI
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 PADANARAM RD APT 218
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-4826
Mailing Address - Country:US
Mailing Address - Phone:845-842-4680
Mailing Address - Fax:
Practice Address - Street 1:34 PADANARAM RD APT 218
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-4826
Practice Address - Country:US
Practice Address - Phone:845-842-4680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT44298164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse