Provider Demographics
NPI:1114488558
Name:HAMMER, ANGIE (NMD)
Entity Type:Individual
Prefix:DR
First Name:ANGIE
Middle Name:
Last Name:HAMMER
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3291 W ROSS DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2364
Mailing Address - Country:US
Mailing Address - Phone:505-412-5719
Mailing Address - Fax:
Practice Address - Street 1:50 S KYRENE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226
Practice Address - Country:US
Practice Address - Phone:505-412-5719
Practice Address - Fax:480-681-5901
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19-1785175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath