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NPI Code Detail

MEDICARE: MARISSA LYNN HAMMERNIK M.S

MEDICARE: MARISSA LYNN HAMMERNIK M.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist13604CA

General Provider Information

NPI Number : 1356776660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA LYNN HAMMERNIK M.S
Provider Business Mailing Address
First Line : 3109 MOUNT PLEASANT ST
Second Line :
City : RACINE
State : WI
Zip : 53404-1511
Country : US
Telephone Number : 262-631-7127
Fax Number :
Provider Business Practice Location Address
First Line : 3109 MOUNT PLEASANT ST
Second Line :
City : RACINE
State : WI
Zip : 53404-1511
Country : US
Telephone Number : 262-631-7127
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2013
Last Update Date : 05/15/2026

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