MEDICARE: MRS. KATHERINE HAMMERSCHMIDT APRN

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	363LA2200X	Adult Health Nurse Practitioner	2017028414	MO

General Provider Information

NPI Number	:	1922517747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHERINE HAMMERSCHMIDT APRN

Provider Business Mailing Address
First Line	:	2587 HICKORY MANOR DR
Second Line	:
City	:	WILDWOOD
State	:	MO
Zip	:	63011-5527
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 DES PERES RD STE 310
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2039
Country	:	US
Telephone Number	:	314-821-1313
Fax Number	:

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

Provider Enumeration Date	:	09/25/2017
Last Update Date	:	09/25/2017

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