Provider Demographics
NPI:1497503510
Name:HAMMER, COREY MICHAEL (RN, BSN, CCRN, CMC)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:MICHAEL
Last Name:HAMMER
Suffix:
Gender:M
Credentials:RN, BSN, CCRN, CMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HAIRPIN DR
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62026-0001
Mailing Address - Country:US
Mailing Address - Phone:618-650-3956
Mailing Address - Fax:
Practice Address - Street 1:6 HAIRPIN DRIVE SIUE
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62026-0001
Practice Address - Country:US
Practice Address - Phone:618-650-3956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program