Individual
ELAINE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
BROOKE ARMY MEDICAL CENTER, 3551 ROGER BROOKE ROAD, FORT SAM HOUSTON, TX 78234-4504
(210) 916-8400
Mailing address
106 NEAL AVE, SAN ANTONIO, TX 78214-1234
(608) 381-5718
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1325-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10004769
—
WI
Enumeration date
06/04/2007
Last updated
05/13/2024
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