Provider Demographics
NPI:1609537810
Name:HERNANDEZ, PATRICIA SUE (APRN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9604 BRAES VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-1903
Mailing Address - Country:US
Mailing Address - Phone:512-925-9373
Mailing Address - Fax:
Practice Address - Street 1:8229 SHOAL CREEK BLVD STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-7556
Practice Address - Country:US
Practice Address - Phone:512-691-7077
Practice Address - Fax:512-691-7080
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1047773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily