Provider Demographics
NPI:1427361302
Name:HERNANDEZ, JUAN FRANCISCO (FNP)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:FRANCISCO
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 ORANGE BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-8355
Mailing Address - Country:US
Mailing Address - Phone:956-645-7453
Mailing Address - Fax:
Practice Address - Street 1:1914 ORANGE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-8355
Practice Address - Country:US
Practice Address - Phone:956-645-7453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX678572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX299688602Medicaid
TXTXB111399Medicare PIN