Individual
JUVY DE LA CERNA HENTHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3524 DAVIESHIRE DR, BARTLETT, TN 38133-0901
(631) 804-8637
Mailing address
3524 DAVIESHIRE DR, BARTLETT, TN 38133-0901
Taxonomy
Speciality
Code
Description
License number
State
163WC3500X
Cardiac Rehabilitation Registered Nurse
757827
NY
163WM0705X
Medical-Surgical Registered Nurse
757827
NY
163WR0006X
Registered Nurse First Assistant
Primary
250557
TN
Other
Enumeration date
12/30/2021
Last updated
12/30/2021
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