Individual ProviderBreanna HernandezCase Manager/Care CoordinatorOther Service ProvidersPractice Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610(505) 268-5295PECOS EnrollmentBased on the most recent information from CMS, provider Breanna 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 12:57 PM.Profile DetailsProvider ID1467049700Provider TypeIndividualFull NameHernandez, BreannaGenderFemaleSole ProprietorNoEnumeration Date12/21/2020Last Updated12/21/2020Contact InformationPractice LocationPractice Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610Phone(505) 268-5295FaxUnlisted FaxMailing LocationMailing Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610Phone(505) 268-5295FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer