Individual
DIANA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
415 COLUMBIA RD, DORCHESTER, MA 02125-2424
(617) 287-8000
Mailing address
415 COLUMBIA RD, DORCHESTER, MA 02125-2424
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN92206
MA
Other
Enumeration date
11/13/2015
Last updated
11/13/2015
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