Provider Demographics
NPI:1124994512
Name:RESONATE LLC
Entity type:Organization
Organization Name:RESONATE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP, CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HERNANDEZ WARE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, PMHNP
Authorized Official - Phone:580-458-9952
Mailing Address - Street 1:1301 NW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-3656
Mailing Address - Country:US
Mailing Address - Phone:580-574-8305
Mailing Address - Fax:
Practice Address - Street 1:1301 NW 40TH ST
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-3656
Practice Address - Country:US
Practice Address - Phone:580-574-8305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty