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Individual

RAELYNN HERNANDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
212 W 13TH ST, PUEBLO, CO 81003-3754
(719) 696-9027
Mailing address
212 W 13TH ST, PUEBLO, CO 81003-3754
(719) 696-9027

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
337495
TX

Other

Enumeration date
01/31/2025
Last updated
01/31/2025
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