1649325010 NPI number — MRS. CYNTHIA L HAMMER RN BSN

Table of content: MRS. CYNTHIA L HAMMER RN BSN (NPI 1649325010)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649325010 NPI number — MRS. CYNTHIA L HAMMER RN BSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMMER
Provider First Name:
CYNTHIA
Provider Middle Name:
L
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN BSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BERGH
Provider Other First Name:
CYNTHIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1649325010
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1330 EAST CARSON DR
Provider Second Line Business Mailing Address:
ARREDONDO ELEMENTARY SCHOOL
Provider Business Mailing Address City Name:
TEMPE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85282
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-897-2744
Provider Business Mailing Address Fax Number:
480-839-7325

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1330 EAST CARSON DR
Provider Second Line Business Practice Location Address:
ARREDONDO ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-897-2744
Provider Business Practice Location Address Fax Number:
480-839-7325
Provider Enumeration Date:
01/24/2007

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: 163W00000X , with the licence number:  076518 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: AHCCCS571093 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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