Provider Demographics
NPI:1942766092
Name:HERNANDEZ, LISA AMBER (APRN, FNP-C,PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:AMBER
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN, FNP-C,PMHNP-BC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, FNP-C,PMHNP-BC
Mailing Address - Street 1:10008 PILOT AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79706-2615
Mailing Address - Country:US
Mailing Address - Phone:432-563-4144
Mailing Address - Fax:432-561-8611
Practice Address - Street 1:10008 PILOT AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79706-2615
Practice Address - Country:US
Practice Address - Phone:432-563-4144
Practice Address - Fax:432-561-8611
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140625208M00000X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily