Individual
MARY M HAMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1203 SMIZER MILL RD, SUITE 105, FENTON, MO 63026-3483
(636) 717-1350
(636) 717-1355
Mailing address
1203 SMIZER MILL RD, SUITE 105, FENTON, MO 63026-3483
(636) 717-1350
(636) 717-1355
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2010035829
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598067779
—
MO
01
—
P01276098
RAILROAD MEDICARE
MO
Enumeration date
11/22/2010
Last updated
04/14/2015
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