Individual
CARLY D HAMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3101 E STATE ST STE 1100, EAGLE, ID 83616-6232
(208) 473-3500
(208) 473-3510
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
(208) 381-6505
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-759
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8081651
—
ID
Enumeration date
01/10/2008
Last updated
11/01/2024
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