Individual provider · Type 1 NPI
Stephanie Mora Hernandez
Primary Care Nurse Practitioner · Chicago, IL
NPI number
1104494665
Active
Practice location
1701 W Superior St
Chicago, IL 60622-5646
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 209. (IL) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | 209023388 (IL) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1104494665
Stephanie Mora Hernandez's National Provider Identifier is 1104494665, issued on Jun 11, 2021. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Chicago, IL. The record was last updated on Aug 10, 2021.