Provider Demographics
NPI:1508267345
Name:GARCIA HERNANDEZ, YOHANNA ADELBA (NP)
Entity Type:Individual
Prefix:
First Name:YOHANNA
Middle Name:ADELBA
Last Name:GARCIA HERNANDEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-2841
Mailing Address - Country:US
Mailing Address - Phone:603-431-2516
Mailing Address - Fax:603-431-9945
Practice Address - Street 1:25 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-2841
Practice Address - Country:US
Practice Address - Phone:603-431-2516
Practice Address - Fax:603-431-9945
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2295985363LF0000X
NH072653-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3103451Medicaid
NHT400271232Medicare PIN
NH3103451Medicaid