MEDICARE: MRS. ALLISON ROSE HAMMER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	209.007786	IL
2	363LP0200X	Pediatric Nurse Practitioner	71009074A	IN

General Provider Information

NPI Number	:	1508191750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALLISON ROSE HAMMER NP

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	575 RILEY HOSPITAL DR STE 2240
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5272
Country	:	US
Telephone Number	:	317-944-8620
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2009
Last Update Date	:	01/18/2021

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