Provider Demographics
NPI:1578647327
Name:HERNANDEZ, IRIS Z (PNP)
Entity Type:Individual
Prefix:MS
First Name:IRIS
Middle Name:Z
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8152 ORCHARD GLEN DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31820-4271
Mailing Address - Country:US
Mailing Address - Phone:706-561-7440
Mailing Address - Fax:706-561-7440
Practice Address - Street 1:7950 MARTIN LOOP
Practice Address - Street 2:
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905-5647
Practice Address - Country:US
Practice Address - Phone:706-544-4239
Practice Address - Fax:706-544-3950
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN158152363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics