MEDICARE: KATHRYN HAMMER APRN, CPNP-PC

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
1	363LP2300X	Primary Care Nurse Practitioner	AP138353	TX

General Provider Information

NPI Number	:	1417509688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN HAMMER APRN, CPNP-PC

Provider Business Mailing Address
First Line	:	1464 E WHITESTONE BLVD STE 2104
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-9079
Country	:	US
Telephone Number	:	512-260-8100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1464 E WHITESTONE BLVD STE 2104
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-9079
Country	:	US
Telephone Number	:	512-260-8100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	01/13/2022

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