Provider Demographics
NPI:1518368992
Name:HAMMEL, MARY AMANDA (APRN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:AMANDA
Last Name:HAMMEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4247 KAPAIA RD
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-8414
Mailing Address - Country:US
Mailing Address - Phone:313-418-1825
Mailing Address - Fax:
Practice Address - Street 1:2970 KELE ST
Practice Address - Street 2:#112-C
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1823
Practice Address - Country:US
Practice Address - Phone:313-418-1825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN1759251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health