Healthcare Provider Details

I. General information

NPI: 1831725977
Provider Name (Legal Business Name): JESSICA HAMMAKER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DRIVE
HERSHEY PA
17033-0858
US

IV. Provider business mailing address

PO BOX 858 MC A410
HERSHEY PA
17033-0858
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-5167
  • Fax: 717-531-7790
Mailing address:
  • Phone: 800-243-1455
  • Fax: 717-531-7790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN627001
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: