Provider Demographics
NPI:1902262900
Name:HERNANDEZ, NAKEISHA A
Entity Type:Individual
Prefix:
First Name:NAKEISHA
Middle Name:A
Last Name: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 1:3419 S HALIFAX WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-3747
Mailing Address - Country:US
Mailing Address - Phone:720-492-5994
Mailing Address - Fax:
Practice Address - Street 1:3419 S HALIFAX WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3747
Practice Address - Country:US
Practice Address - Phone:720-492-5994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty