Individual
NICOLE RENEE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8530 FIRESTONE BLVD, DOWNEY, CA 90241-4926
(562) 867-7999
Mailing address
8530 FIRESTONE BLVD, DOWNEY, CA 90241-4926
(562) 867-7999
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95122725
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95019511
CA
363LP2300X
Primary Care Nurse Practitioner
F07211198
CA
Other
Enumeration date
09/14/2021
Last updated
08/08/2023
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