Provider Demographics
NPI:1750802757
Name:HERNANDEZ, ELISA SAN ANDRES (APRN)
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:SAN ANDRES
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9179 GRISSOM RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-2810
Mailing Address - Country:US
Mailing Address - Phone:210-680-8081
Mailing Address - Fax:210-680-3179
Practice Address - Street 1:9179 GRISSOM RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-2810
Practice Address - Country:US
Practice Address - Phone:210-680-8081
Practice Address - Fax:210-680-3179
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP134190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily