Provider Demographics
NPI:1679935142
Name:EVANS-HAMER, HANNAH MAE (MD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MAE
Last Name:EVANS-HAMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MAE
Other - Last Name:LA BELLE-HAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13001 E 17TH PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2570
Mailing Address - Country:US
Mailing Address - Phone:720-777-6738
Mailing Address - Fax:
Practice Address - Street 1:2900 E 136TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3542
Practice Address - Country:US
Practice Address - Phone:303-996-6005
Practice Address - Fax:303-420-8831
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0062174208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000173339Medicaid