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Individual

KATHY SUSAN HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1032 S CESAR E CHAVEZ DR, MILWAUKEE, WI 53204-2203
(414) 672-1353
(414) 672-4265
Mailing address
1032 S CESAR E CHAVEZ DR, MILWAUKEE, WI 53204-2203
(414) 672-1353
(414) 672-4265

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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