Provider Demographics
NPI:1669046926
Name:HERNANDEZ, LASHARON (APRN PMHNP)
Entity type:Individual
Prefix:
First Name:LASHARON
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 AMITY RD
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:CT
Mailing Address - Zip Code:06524-3091
Mailing Address - Country:US
Mailing Address - Phone:475-262-9608
Mailing Address - Fax:475-275-7247
Practice Address - Street 1:649 AMITY RD
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:CT
Practice Address - Zip Code:06524-3091
Practice Address - Country:US
Practice Address - Phone:475-262-9608
Practice Address - Fax:475-275-7247
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12360363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health