Provider Demographics
NPI:1942500277
Name:LUIS-HERNANDEZ, HERNAN (RNBSN)
Entity Type:Individual
Prefix:MR
First Name:HERNAN
Middle Name:
Last Name:LUIS-HERNANDEZ
Suffix:
Gender:M
Credentials:RNBSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 STREET BO CACAO
Mailing Address - Street 2:HC-01 BOX 4888
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-9210
Mailing Address - Country:US
Mailing Address - Phone:787-234-7279
Mailing Address - Fax:
Practice Address - Street 1:120 STREET ANTIGUO HOSPITAL DE DISTRITO- ASSMCA
Practice Address - Street 2:COTTO STATION BOX 9550
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-878-3552
Practice Address - Fax:787-879-8633
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21051163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult