Provider Demographics
NPI:1053062521
Name:HAMM, CHASTITY JANE (MA)
Entity Type:Individual
Prefix:
First Name:CHASTITY
Middle Name:JANE
Last Name:HAMM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13150 MILTON ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:OH
Mailing Address - Zip Code:43569-9658
Mailing Address - Country:US
Mailing Address - Phone:419-575-4262
Mailing Address - Fax:
Practice Address - Street 1:13150 MILTON ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:OH
Practice Address - Zip Code:43569-9658
Practice Address - Country:US
Practice Address - Phone:419-575-4262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty