Provider Demographics
NPI:1851067821
Name:HAMMERMEISTER, MIRANDA ANN (MSN, NNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:ANN
Last Name:HAMMERMEISTER
Suffix:
Gender:F
Credentials:MSN, NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3080 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4686
Mailing Address - Country:US
Mailing Address - Phone:409-212-7320
Mailing Address - Fax:
Practice Address - Street 1:3080 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4686
Practice Address - Country:US
Practice Address - Phone:409-212-7320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1051468363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care