Provider Demographics
NPI:1679175376
Name:HERNON, KATHERYN DANIELLE (LVN)
Entity Type:Individual
Prefix:MS
First Name:KATHERYN
Middle Name:DANIELLE
Last Name:HERNON
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 1:26 BADGERS HLS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1374
Mailing Address - Country:US
Mailing Address - Phone:619-709-9636
Mailing Address - Fax:
Practice Address - Street 1:26 BADGERS HLS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1374
Practice Address - Country:US
Practice Address - Phone:619-709-9636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1017634164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse