Individual
MALLORI WEAVER HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11673 JOLLYVILLE RD STE 202, AUSTIN, TX 78759-4211
(512) 342-7979
(512) 637-2596
Mailing address
10500 LAKELINE MALL DR APT 4202, AUSTIN, TX 78717-0078
(512) 214-2700
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1057095
TX
Other
Enumeration date
10/18/2021
Last updated
06/08/2023
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