Provider Demographics
NPI:1336827260
Name:HERNANDEZ, JENNIFER L (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17183 INTERSTATE 45 S STE 110
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3313
Mailing Address - Country:US
Mailing Address - Phone:936-270-3480
Mailing Address - Fax:936-270-3490
Practice Address - Street 1:17183 INTERSTATE 45 S STE 110
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-3313
Practice Address - Country:US
Practice Address - Phone:936-270-3480
Practice Address - Fax:936-270-3490
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX983495163WX0200X
TX1093379363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0200XNursing Service ProvidersRegistered NurseOncology