Provider Demographics
NPI:1023868460
Name:HAMMER, CHERYL SUZANNE (LPN)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:SUZANNE
Last Name:HAMMER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 NE WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-2652
Mailing Address - Country:US
Mailing Address - Phone:360-748-2234
Mailing Address - Fax:
Practice Address - Street 1:727 N TOWER AVE
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-4754
Practice Address - Country:US
Practice Address - Phone:360-557-2027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00053616164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse