Provider Demographics
NPI:1912548058
Name:LAMM, HANNAH RAE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:RAE
Last Name:LAMM
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 ROGERS AVE STE 401A
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4034
Mailing Address - Country:US
Mailing Address - Phone:479-314-4650
Mailing Address - Fax:479-452-9459
Practice Address - Street 1:7001 ROGERS AVE STE 401A
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4034
Practice Address - Country:US
Practice Address - Phone:479-314-4650
Practice Address - Fax:479-452-9459
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR121998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty