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NPI Code Detail

MEDICARE: SUSAN ANN HAMANN RN

MEDICARE: SUSAN ANN HAMANN 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
1163WN1003XNutrition Support Registered NurseRN124726OH

General Provider Information

NPI Number : 1639725179
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ANN HAMANN RN
Provider Business Mailing Address
First Line : 464 RICHMOND RD STE 202
Second Line :
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2704
Country : US
Telephone Number : 330-824-4200
Fax Number : 440-525-5564
Provider Business Practice Location Address
First Line : 464 RICHMOND RD STE 202
Second Line :
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2704
Country : US
Telephone Number : 330-824-4200
Fax Number : 440-525-5564
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2019
Last Update Date : 08/12/2019

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