Provider Demographics
NPI:1700486990
Name:HAMM, NATASHA MILDRED
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:MILDRED
Last Name:HAMM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 PEACH BLOSSOM CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-1621
Mailing Address - Country:US
Mailing Address - Phone:614-817-8260
Mailing Address - Fax:
Practice Address - Street 1:4806 KINGSHILL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-6204
Practice Address - Country:US
Practice Address - Phone:614-781-0854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRT086943251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health