MEDICARE: DAVID HAMLEY RN

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	163WN0800X	Neuroscience Registered Nurse	R 129976-8	MN

General Provider Information

NPI Number	:	1598883951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID HAMLEY RN

Provider Business Mailing Address
First Line	:	5775 WAYZATA BLVD
Second Line	:	SUITE 200
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-1222
Country	:	US
Telephone Number	:	952-525-4511
Fax Number	:	952-525-1560

Provider Business Practice Location Address
First Line	:	5775 WAYZATA BLVD
Second Line	:	SUITE 200
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-1222
Country	:	US
Telephone Number	:	952-525-4511
Fax Number	:	952-525-1560

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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