Provider Demographics
NPI:1366203119
Name:HERNANDEZ, CLAUDIA IVET (CNA)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:IVET
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:IVET
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-0506
Mailing Address - Country:US
Mailing Address - Phone:701-352-8070
Mailing Address - Fax:
Practice Address - Street 1:1355 EASTVIEW DR
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1948
Practice Address - Country:US
Practice Address - Phone:701-352-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND45096376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide