Individual
ENRIQUE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4605 E ELWOOD ST STE 500, PHOENIX, AZ 85040-1978
(602) 200-9021
Mailing address
2221 LAKESIDE BLVD STE 600, RICHARDSON, TX 75082-4416
(972) 761-5509
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
252210
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/16/2019
Last updated
09/17/2021
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