Provider Demographics
NPI:1326794553
Name:HUMMEL, JEFFREY (APRN)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:HUMMEL
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 OXEN VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:UHLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2328
Mailing Address - Country:US
Mailing Address - Phone:512-945-2901
Mailing Address - Fax:
Practice Address - Street 1:204 OXEN VALLEY WAY
Practice Address - Street 2:
Practice Address - City:UHLAND
Practice Address - State:TX
Practice Address - Zip Code:78640-2328
Practice Address - Country:US
Practice Address - Phone:512-945-2901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1071831363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care