Nicole Hernandez, MSN, CPNP-PC
Nurse Practitioner, Pediatrics in Fair Lawn, NJ. Individual provider (NPI-1).
NPI number1124875158
StatusActive
Last updated in NPPESMay 6, 2024
Details
- NPI
- 1124875158
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Nicole Hernandez
- Credential
- MSN, CPNP-PC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 6, 2024
- Certification date
- May 6, 2024
- Last updated
- May 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 26NJ01062400 | NJ | Yes |
Other names
- Nicole Bacza (Former Name)
Practice location
23-00 Route 208 Ste 1-5Fair Lawn, NJ 07410-1555
Phone 201-797-1900
Mailing address
23-00 Route 208 Ste 1-5Fair Lawn, NJ 07410-1555
Phone 201-797-1900
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