Healthcare Provider Details

I. General information

NPI: 1669614673
Provider Name (Legal Business Name): BRENDA L HAMEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 04/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 WALKER LN
FREMONT NH
03044-3527
US

IV. Provider business mailing address

PO BOX 774
KINGSTON NH
03848-0774
US

V. Phone/Fax

Practice location:
  • Phone: 603-303-3583
  • Fax:
Mailing address:
  • Phone: 603-303-3583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number274999
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: