Individual
MRS. JACQUELINE MARIE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1323A INDIANA AVE, SHEBOYGAN, WI 53081-4848
(920) 254-3037
Mailing address
1323A INDIANA AVE, SHEBOYGAN, WI 53081-4848
(920) 254-3037
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
312564-31
WI
Other
Enumeration date
06/01/2010
Last updated
06/01/2010
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