Provider Demographics
NPI:1619165636
Name:DARREN J HAMMERGREN LLC
Entity Type:Organization
Organization Name:DARREN J HAMMERGREN LLC
Other - Org Name:DARREN J HAMMERGREN NP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMMERGREN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:520-747-2861
Mailing Address - Street 1:5920 E PIMA ST STE 140
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4380
Mailing Address - Country:US
Mailing Address - Phone:520-747-2861
Mailing Address - Fax:520-733-3444
Practice Address - Street 1:5920 E PIMA ST STE 140
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4380
Practice Address - Country:US
Practice Address - Phone:520-747-2861
Practice Address - Fax:520-733-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP 2617363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ117809Medicare PIN