Healthcare Provider Details

I. General information

NPI: 1598538779
Provider Name (Legal Business Name): ALEXANDRA EVELYN HAMMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 MANORHAVEN DR
DURHAM NC
27703-6809
US

IV. Provider business mailing address

1080 MANORHAVEN DR
DURHAM NC
27703-6809
US

V. Phone/Fax

Practice location:
  • Phone: 610-513-7727
  • Fax:
Mailing address:
  • Phone: 610-513-7727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number360241
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: