Provider Demographics
NPI:1801594841
Name:HERNANDEZ, REBECCA NOEMI (CNM)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:NOEMI
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:NOEMI
Other - Last Name:ARBOLEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:15730 EASTHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-2614
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3449 WILKENS AVE STE 305
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5218
Practice Address - Country:US
Practice Address - Phone:410-644-6232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR268904367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife