Provider Demographics
NPI:1467201624
Name:FERNANDEZ, ERLEEN SOLON (MSN, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:ERLEEN
Middle Name:SOLON
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 LINDEN AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-5446
Mailing Address - Country:US
Mailing Address - Phone:650-588-5458
Mailing Address - Fax:
Practice Address - Street 1:82 LINDEN AVE APT 3
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-5446
Practice Address - Country:US
Practice Address - Phone:650-588-5458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF95027583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily