Provider Demographics
NPI:1104420439
Name:HAMMES, LORI ANN (CDAC, CNA)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:HAMMES
Suffix:
Gender:F
Credentials:CDAC, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SIGOURNEY
Mailing Address - State:IA
Mailing Address - Zip Code:52591-1207
Mailing Address - Country:US
Mailing Address - Phone:641-541-0249
Mailing Address - Fax:
Practice Address - Street 1:224 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:SIGOURNEY
Practice Address - State:IA
Practice Address - Zip Code:52591-1207
Practice Address - Country:US
Practice Address - Phone:641-541-0249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAX000501127Medicaid