Individual
LIZETTE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
702 N GRAND ST, ENID, OK 73701-3221
(580) 234-3791
Mailing address
702 N GRAND ST, ENID, OK 73701-3221
(580) 324-3791
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0071279
OK
Other
Enumeration date
01/24/2022
Last updated
01/24/2022
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