Individual
STACY DIANNE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
645 PARFET ST, LAKEWOOD, CO 80215-5574
(303) 239-7032
Mailing address
645 PARFET ST, LAKEWOOD, CO 80215-5574
(303) 239-7032
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001243849
VA
Other
Enumeration date
03/23/2015
Last updated
03/20/2017
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