Provider Demographics
NPI:1851945521
Name:HERNANDEZ, LARA S (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:LARA
Middle Name:S
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 HOUMA BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2938
Mailing Address - Country:US
Mailing Address - Phone:504-503-7003
Mailing Address - Fax:504-503-7004
Practice Address - Street 1:4224 HOUMA BLVD STE 530
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2938
Practice Address - Country:US
Practice Address - Phone:504-503-7003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily