Provider Demographics
NPI:1790096832
Name:HAMMEL, RIKKI J (NP)
Entity Type:Individual
Prefix:
First Name:RIKKI
Middle Name:J
Last Name:HAMMEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RIKKI
Other - Middle Name:J
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-683-5278
Mailing Address - Fax:920-686-9674
Practice Address - Street 1:1515 RANDOLPH CT
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-8345
Practice Address - Country:US
Practice Address - Phone:920-683-5278
Practice Address - Fax:620-482-0359
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4072-033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1790096832Medicaid
WI4072-033OtherSTATE LICENSE
WI4072-033OtherSTATE LICENSE
WI1790096832Medicaid