Individual ProviderJesus A. HernandezNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 Hawthorne Lane, Charlotte, NC 28204(704) 384-6296PECOS EnrollmentBased on the most recent information from CMS, provider Jesus A. Hernandez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:59 PM.Profile DetailsProvider ID1689894784Provider TypeIndividualFull NameHernandez, Jesus A.CredentialNPGenderMaleSole ProprietorNoEnumeration Date4/30/2007Last Updated9/6/2012Contact InformationPractice LocationPractice Address200 Hawthorne Lane, Charlotte, NC 28204Phone(704) 384-6296Fax(704) 384-6533Mailing LocationMailing Address200 Hawthorne Lane, Charlotte, NC 28204Phone(704) 384-6296Fax(704) 384-6533Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense201059North Carolina