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Individual

JESUS HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
510 E LISA DR, CHAPARRAL, NM 88081
(575) 824-0820
(575) 824-1021
Mailing address
385 CALLE DE ALEGRA, BLDG. A, LAS CRUCES, NM 88005-3417
(575) 526-1105
(575) 524-4266

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-01621
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
28820533
NM
01
NMA100721
MEDICARE
NM
Enumeration date
06/11/2010
Last updated
08/28/2018
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