1285839092 NPI number — MRS. TARYN J HAMRE APRN

Table of content: MRS. TARYN J HAMRE APRN (NPI 1285839092)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285839092 NPI number — MRS. TARYN J HAMRE APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMRE
Provider First Name:
TARYN
Provider Middle Name:
J
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
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:
1285839092
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
282 WASHINGTON STREET
Provider Second Line Business Mailing Address:
CONNECTICUT CHILDREN'S MEDICAL CENTER
Provider Business Mailing Address City Name:
HARTFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-545-9630
Provider Business Mailing Address Fax Number:
860-545-9622

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CONNECTICUT CHILDREN'S MEDICAL CENTER
Provider Second Line Business Practice Location Address:
282 WASHINGTON STREET
Provider Business Practice Location Address City Name:
HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-545-9630
Provider Business Practice Location Address Fax Number:
860-545-9622
Provider Enumeration Date:
06/20/2007

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: 363LF0000X , with the licence number:  002989 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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