Provider Demographics
NPI:1992536510
Name:PLUTIN HERNANDEZ, LILIBET
Entity type:Individual
Prefix:
First Name:LILIBET
Middle Name:
Last Name:PLUTIN HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 ARANSAS RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-2475
Mailing Address - Country:US
Mailing Address - Phone:737-888-9110
Mailing Address - Fax:
Practice Address - Street 1:106 ARANSAS RIVER RD
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-2475
Practice Address - Country:US
Practice Address - Phone:737-888-9110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1062072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily