1366815102 NPI number — MRS. CIARA LUCINDA HAMMER FNP, NP-C

Table of content: MRS. CIARA LUCINDA HAMMER FNP, NP-C (NPI 1366815102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366815102 NPI number — MRS. CIARA LUCINDA HAMMER FNP, NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMMER
Provider First Name:
CIARA
Provider Middle Name:
LUCINDA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP, NP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366815102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3276
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EVANSVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47731-3276
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-473-0181
Provider Business Mailing Address Fax Number:
812-473-5822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4727 ROSEBUD LN
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
NEWBURGH
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47630-9367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-490-5200
Provider Business Practice Location Address Fax Number:
812-490-5203
Provider Enumeration Date:
11/02/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WG0000X , with the licence number:  28192121A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 71006053A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: F0116702 . This is a "BOARD CERTIFICATION- AANP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201346120 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100403070 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 71006053B . This is a "CSR" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: P01616062 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000996591 . This is a "ANTHEM BCBS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: PMORRIS2016 . This is a "LICENSE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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