Provider Demographics
NPI:1578731980
Name:HAMMACK-BURNS, MICHELLE ANN (CPHT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:HAMMACK-BURNS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 CLARK RD STE B
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-4167
Mailing Address - Country:US
Mailing Address - Phone:530-877-4981
Mailing Address - Fax:530-877-1048
Practice Address - Street 1:6240 CLARK RD STE B
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-4167
Practice Address - Country:US
Practice Address - Phone:530-877-4981
Practice Address - Fax:530-877-1048
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81421183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician