Sueellen Hernandez, LVN

Individual provider Active NPI Licensed Vocational Nurse · Brady, TX

NPI 1629575162 · NPPES record last updated Apr 11, 2018

Key facts

NPI
1629575162
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
212351 (TX)
Practice address
803 E 11TH St
Brady, TX 76825-5912
Phone
(325) 240-9068
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
212351TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 212351 TX Yes

Addresses

Primary practice location

803 E 11TH St
Brady, TX 76825-5912

Mailing address

803 E 11TH St
Brady, TX 76825-5912
Phone (325) 240-9068

Other providers in Brady, TX

All providers in Brady, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.