Provider Demographics
NPI:1245702133
Name:HERNANDEZ, JASMIN ANDREA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JASMIN
Middle Name:ANDREA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:JASMIN
Other - Middle Name:ANDREA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6201 LEESBURG PIKE STE 410
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2201
Mailing Address - Country:US
Mailing Address - Phone:703-703-5325
Mailing Address - Fax:
Practice Address - Street 1:6201 LEESBURG PIKE STE 410
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2201
Practice Address - Country:US
Practice Address - Phone:703-532-5044
Practice Address - Fax:703-532-5944
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001231271207R00000X
VA0024177025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine