Provider Demographics
NPI:1114269974
Name:HERNANDEZ, PATRICIA E (NP-C)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:E
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10479 ALPHARETTA ST STE 18
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-3764
Mailing Address - Country:US
Mailing Address - Phone:678-869-5000
Mailing Address - Fax:678-869-5014
Practice Address - Street 1:10479 ALPHARETTA ST STE 18
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075
Practice Address - Country:US
Practice Address - Phone:678-869-5000
Practice Address - Fax:678-869-5014
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA220723363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily