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General NPI Number Information
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NPI Number | 1306503073
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Entity Type | Organization
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Legal Business Name | DR KRISTINA HAMMER MSPAC DMSC LLC
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Dates
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Enumeration Date | 11/17/2021
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 11300 EAGLE ROCK AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-4112
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Country | US
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Telephone | 505-382-4106
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Fax |
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Provider Business Mailing Address
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Address Line | 11300 EAGLE ROCK AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-4112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTINA HAMMER
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Credential |
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Telephone | 505-382-4106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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