# KELLY S HAMMARBERG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1326362047
- **Gender:** F
- **Credential:** CRNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | RN525635L | PA | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | SP013010 | PA | Yes |

## Other

- **Enumeration date:** 03/24/2010
- **Last updated:** 02/08/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 102885219 | — | PA |
| 01 | — | RN525635L | STATE LICENSE - RN | PA |
| 01 | — | SP013010 | STATE LICENSE - CRNP | PA |
| 01 | — | SW123688 | STATE LICENSE - SOCIAL WORKER | PA |