Provider Demographics
NPI:1205682143
Name:HERNANDEZ, MONICA LEE (AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:LEE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7228 KENSSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-3161
Mailing Address - Country:US
Mailing Address - Phone:440-521-2396
Mailing Address - Fax:
Practice Address - Street 1:7228 KENSSINGTON DR
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-3161
Practice Address - Country:US
Practice Address - Phone:440-521-2396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0036295363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner