Basic Information
| Provider Information | |||||||||
| NPI: | 1508267345 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARCIA HERNANDEZ | ||||||||
| FirstName: | YOHANNA | ||||||||
| MiddleName: | ADELBA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 NEW HAMPSHIRE AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | PORTSMOUTH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038012841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034312516 | ||||||||
| FaxNumber: | 6034319945 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 NEW HAMPSHIRE AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | PORTSMOUTH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038012841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034312516 | ||||||||
| FaxNumber: | 6034319945 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2014 | ||||||||
| LastUpdateDate: | 02/24/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 2295985 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 072653-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 3103451 | 05 | NH | MEDICAID |