Individual
SISSI D. HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7474 GREENWAY CENTER DR, GREENBELT, MD 20770-3504
(301) 441-3050
Mailing address
7474 GREENWAY CENTER DR, GREENBELT, MD 20770-3504
(301) 441-3050
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN237980
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R237980
CRNP LICENSE
MD
Enumeration date
12/13/2019
Last updated
05/11/2020
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