Healthcare Provider Details

I. General information

NPI: 1336230697
Provider Name (Legal Business Name): WENDY E HAMMERLUN LIMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W 9TH ST SUITE C
COZAD NE
69130-1739
US

IV. Provider business mailing address

PO BOX 341
COZAD NE
69130-0341
US

V. Phone/Fax

Practice location:
  • Phone: 308-325-0377
  • Fax: 308-784-3351
Mailing address:
  • Phone: 308-325-0377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2697
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1131
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: