Provider Demographics
NPI:1972830651
Name:HERNANDEZ, MARICELA (RN FNP-BC)
Entity type:Individual
Prefix:
First Name:MARICELA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-3720
Mailing Address - Fax:956-362-3737
Practice Address - Street 1:505 ANGELITA DR STE 14
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78599-8694
Practice Address - Country:US
Practice Address - Phone:956-362-3720
Practice Address - Fax:956-362-3737
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX613738363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily