Provider Demographics
NPI:1629553466
Name:HERNANDEZ, CYNTHIA (LVN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 GUADALAJARA DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-4410
Mailing Address - Country:US
Mailing Address - Phone:830-513-9513
Mailing Address - Fax:
Practice Address - Street 1:944 GUADALAJARA DR
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4410
Practice Address - Country:US
Practice Address - Phone:830-513-9513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX157783164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse