Healthcare Provider Details

I. General information

NPI: 1538728035
Provider Name (Legal Business Name): BRENDA LYNN HAMER APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2019
Last Update Date: 06/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4821 ROBERTS RD
COLUMBUS OH
43228-9496
US

IV. Provider business mailing address

445 E ROYAL FOREST BLVD
COLUMBUS OH
43214-1809
US

V. Phone/Fax

Practice location:
  • Phone: 614-619-6224
  • Fax:
Mailing address:
  • Phone: 614-619-6224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.024778
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.353250
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: