Provider Demographics
NPI:1972907533
Name:HERNANDEZ QUILES, GISELLE (CRNA)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:
Last Name:HERNANDEZ QUILES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 BRANNING RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-6227
Mailing Address - Country:US
Mailing Address - Phone:787-453-4211
Mailing Address - Fax:
Practice Address - Street 1:2314 BRANNING RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-6227
Practice Address - Country:US
Practice Address - Phone:787-453-4211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL46251367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered