Individual
ANTHONY HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
538 N 33RD ST, SPRINGFIELD, OR 97478-5842
(541) 914-5384
Mailing address
538 N 33RD ST, SPRINGFIELD, OR 97478-5842
(541) 914-5384
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
201110511CNA
OR
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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