Provider Demographics
NPI:1134240542
Name:HERNANDEZ, NORMA MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:MARIE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13594 MOUNTAIN TOP DR
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-6538
Mailing Address - Country:US
Mailing Address - Phone:760-288-0258
Mailing Address - Fax:760-288-3738
Practice Address - Street 1:13594 MOUNTAIN TOP DR
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6538
Practice Address - Country:US
Practice Address - Phone:760-288-0258
Practice Address - Fax:760-288-3738
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA487024283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital