Individual
MICHELLE LYNN HERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
109 KENTUCKY ST, DYESS AFB, TX 79607-1007
(325) 513-2435
Mailing address
109 KENTUCKY ST, DYESS AFB, TX 79607-1007
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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