1427576651 NPI number — MICHELLE LYNN HAMMER APRN

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427576651 NPI number — MICHELLE LYNN HAMMER APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMMER
Provider First Name:
MICHELLE
Provider Middle Name:
LYNN
Provider Name Prefix Text:
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:
RYNES
Provider Other First Name:
MICHELLE
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427576651
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 S MAPLE STREET, SUITE 200
Provider Second Line Business Mailing Address:
PO BOX 544
Provider Business Mailing Address City Name:
PLAINVIEW
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68769-4154
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-582-4797
Provider Business Mailing Address Fax Number:
402-582-3779

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 S MAPLE ST STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINVIEW
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68769-4154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-582-4797
Provider Business Practice Location Address Fax Number:
402-582-3779
Provider Enumeration Date:
09/08/2017

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:  112214 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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