Healthcare Provider Details

I. General information

NPI: 1841612850
Provider Name (Legal Business Name): EMILY SUZANNE HAMMER WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2014
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PROGRESS POINT PKWY SUITE 200
O FALLON MO
63368-2206
US

IV. Provider business mailing address

20 PROGRESS POINT PKWY SUITE 200
O FALLON MO
63368-2206
US

V. Phone/Fax

Practice location:
  • Phone: 636-926-0404
  • Fax: 636-477-6646
Mailing address:
  • Phone: 636-926-0404
  • Fax: 636-477-6646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number2013043334
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: