Individual
SERENA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2240 WINROW RD, FORT HUACHUCA, AZ 85613-5080
(520) 533-9034
Mailing address
2240 WINROW RD, FORT HUACHUCA, AZ 85613-5080
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP049815
AZ
Other
Enumeration date
01/29/2016
Last updated
01/29/2016
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