Provider Demographics
NPI:1871874925
Name:HERNANDEZ, DIANA ELIZABETH (FNP-BC)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:ELIZABETH
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 BLEECKER ST # 151
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2410
Mailing Address - Country:US
Mailing Address - Phone:800-731-4254
Mailing Address - Fax:205-332-1383
Practice Address - Street 1:330 N OHIO AVE
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-2728
Practice Address - Country:US
Practice Address - Phone:956-565-1561
Practice Address - Fax:956-565-5373
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2011009619363LF0000X
TXAP120699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily