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NPI Code Detail

MEDICARE: JAN HUMMER

MEDICARE: JAN HUMMER
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1639763295
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAN HUMMER
Provider Business Mailing Address
First Line : 7310 PIN OAK DR
Second Line :
City : MIDDLETOWN
State : MD
Zip : 21769-7621
Country : US
Telephone Number : 304-839-5128
Fax Number :
Provider Business Practice Location Address
First Line : 7310 PIN OAK DR
Second Line :
City : MIDDLETOWN
State : MD
Zip : 21769-7621
Country : US
Telephone Number : 304-839-5128
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2021
Last Update Date : 02/24/2021

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Directions to “ JAN HUMMER ” Practice Location

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