Provider Demographics
NPI:1730460593
Name:HERNANDEZ, EVETTE M (NP, CNM)
Entity Type:Individual
Prefix:
First Name:EVETTE
Middle Name:M
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:NP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1071 CARE WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8431
Mailing Address - Country:US
Mailing Address - Phone:540-374-3100
Mailing Address - Fax:540-374-3102
Practice Address - Street 1:1071 CARE WAY STE 101
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8431
Practice Address - Country:US
Practice Address - Phone:540-374-3100
Practice Address - Fax:540-374-3102
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001285033163W00000X
VA0024177264207V00000X, 363L00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner