Provider Demographics
NPI:1174390272
Name:HAMBLEN, ALAN
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:HAMBLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3405
Mailing Address - Country:US
Mailing Address - Phone:913-579-4770
Mailing Address - Fax:816-221-9121
Practice Address - Street 1:2029 BUCHANAN ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3405
Practice Address - Country:US
Practice Address - Phone:913-579-4770
Practice Address - Fax:816-221-9121
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician