Provider Demographics
NPI:1528530052
Name:HERNANDEZ, DONNA JEWEL (LVN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:JEWEL
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:JEWEL
Other - Last Name:LOVELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14068 S FM 148
Mailing Address - Street 2:
Mailing Address - City:SCURRY
Mailing Address - State:TX
Mailing Address - Zip Code:75158-4393
Mailing Address - Country:US
Mailing Address - Phone:214-607-7382
Mailing Address - Fax:
Practice Address - Street 1:14068 S FM 148
Practice Address - Street 2:
Practice Address - City:SCURRY
Practice Address - State:TX
Practice Address - Zip Code:75158-4393
Practice Address - Country:US
Practice Address - Phone:214-607-7382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX161877164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse