Kelly Vanessa Hernandez Jr.
Technician, Personal Care Attendant in College Park, MD. Individual provider (NPI-1).
NPI number1164048666
StatusActive
Last updated in NPPESJun 19, 2020
Details
- NPI
- 1164048666
- Entity type
- Individual (NPI-1)
- Name
- Kelly Vanessa Hernandez Jr.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 19, 2020
- Certification date
- Jun 19, 2020
- Last updated
- Jun 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | Active | MD | Yes |
Practice location
4709 Cherry Hill RdCollege Park, MD 20740-1329
Phone 240-701-1132
Mailing address
4709 Cherry Hill RdCollege Park, MD 20740-1329
Phone 240-701-1132
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