Provider Demographics
NPI:1952357154
Name:HERNANDEZ, CINDY (APMHNP)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 520
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MS
Mailing Address - Zip Code:39342-0520
Mailing Address - Country:US
Mailing Address - Phone:601-453-5393
Mailing Address - Fax:888-735-7202
Practice Address - Street 1:5000 HIGHWAY 39 N
Practice Address - Street 2:SUITE B
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-1021
Practice Address - Country:US
Practice Address - Phone:601-453-5366
Practice Address - Fax:888-735-7202
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2013-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9242866363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
2005009635-34OtherAMNURSECREDCNTR
MS00080075Medicaid
FL3077691 00Medicaid
MSR869647OtherMS BD OF NURSING
FL3077691 00Medicaid
FLU8543ZMedicare ID - Type Unspecified
MS00080075Medicaid