Provider Demographics
NPI:1861139479
Name:HERNANDEZ, ANYSSA NOELLE (MSN, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:ANYSSA
Middle Name:NOELLE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 S. ALAMEDA ST.
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411
Mailing Address - Country:US
Mailing Address - Phone:361-888-6782
Mailing Address - Fax:361-888-6788
Practice Address - Street 1:3318 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1821
Practice Address - Country:US
Practice Address - Phone:361-883-3683
Practice Address - Fax:361-653-0717
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073612363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily