Individual
MICHELLE JANETTE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
260 S CENTRAL CAMPUS DR, SALT LAKE CITY, UT 84112-9199
(801) 581-4697
Mailing address
1168 E PARKWAY AVE, SALT LAKE CITY, UT 84106-2783
(951) 704-9709
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
11803243-3102
UT
163W00000X
Registered Nurse
95335899
CA
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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