Provider Demographics
NPI:1366482440
Name:HUMMEL, RYAN S
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:S
Last Name:HUMMEL
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 1:207 PLUM ST
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-2328
Mailing Address - Country:US
Mailing Address - Phone:651-388-2670
Mailing Address - Fax:651-388-9471
Practice Address - Street 1:1692 COMMERCE CT
Practice Address - Street 2:
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022-3242
Practice Address - Country:US
Practice Address - Phone:715-425-7905
Practice Address - Fax:715-425-8016
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7370237600000X
WI400156237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter