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Individual
KATHY SUSAN HERNANDEZ
Active
Individual
KATHY SUSAN HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32458
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31735400
—
WI
01
—
3596782
CIGNA
WI
01
—
4654337
AETNA
WI
01
—
810127286
PRIVATEHEALTHCARE SYSTEM
WI
Enumeration date
06/20/2005
Last updated
03/07/2023
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