Individual
AMANDA MAE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5714 S WESTERN AVE, OKLAHOMA CITY, OK 73109-4515
(405) 601-1154
(405) 601-1183
Mailing address
5714 S WESTERN AVE, OKLAHOMA CITY, OK 73109-4515
(405) 601-1154
(405) 601-1183
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0052603
OK
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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