Healthcare Provider Details

I. General information

NPI: 1164882841
Provider Name (Legal Business Name): REBECCA HAMMOOR BSN, RN, CPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE # MLC2020
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE # MLC2020
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-9091
  • Fax:
Mailing address:
  • Phone: 513-636-9091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number196332
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: