Provider Demographics
NPI:1457373219
Name:HAMMIG, MEREDITH S (CNM)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:S
Last Name:HAMMIG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 DOMINICAN WAY
Mailing Address - Street 2:STE B
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1526
Mailing Address - Country:US
Mailing Address - Phone:831-479-4966
Mailing Address - Fax:831-479-4967
Practice Address - Street 1:1779 DOMINICAN WAY
Practice Address - Street 2:STE B
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1526
Practice Address - Country:US
Practice Address - Phone:831-479-4966
Practice Address - Fax:831-479-4967
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN1566367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0081501OtherMEDI-CAL
CAGR0081500Medicaid
RN1566Medicare UPIN
CA222149732Medicare ID - Type Unspecified