Provider Demographics
NPI:1992387682
Name:HAMM, JEFF ALAN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:ALAN
Last Name:HAMM
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6905 FIELDBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502-9575
Mailing Address - Country:US
Mailing Address - Phone:937-308-6358
Mailing Address - Fax:
Practice Address - Street 1:6905 FIELDBROOK DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45502-9575
Practice Address - Country:US
Practice Address - Phone:937-308-6358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN250284163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency