Provider Demographics
NPI:1477545788
Name:HERNANDEZ-PARKHURST, ANNETTE M (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:M
Last Name:HERNANDEZ-PARKHURST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:M
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 W IRVINGTON RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85714-3054
Mailing Address - Country:US
Mailing Address - Phone:520-884-9287
Mailing Address - Fax:520-623-0992
Practice Address - Street 1:225 W IRVINGTON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-3054
Practice Address - Country:US
Practice Address - Phone:520-884-9287
Practice Address - Fax:520-623-0992
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30162207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ703373Medicaid
AZ703373Medicaid
AZ70642Medicare ID - Type Unspecified