Provider Demographics
NPI:1699147751
Name:HERNANDEZ, JENNA LEIGH (CNM)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:LEIGH
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:LEIGH
Other - Last Name:BRUCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:12074 CANYON ROCK LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2456
Mailing Address - Country:US
Mailing Address - Phone:210-854-3345
Mailing Address - Fax:
Practice Address - Street 1:12074 CANYON ROCK LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-2456
Practice Address - Country:US
Practice Address - Phone:210-854-3345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129653367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife