Individual
MARISSA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 DOUGLAS AVE, LAS VEGAS, NM 87701-3947
(505) 617-1180
Mailing address
710 DOUGLAS AVE, LAS VEGAS, NM 87701-3947
(505) 617-1180
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
07/29/2025
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