Provider Demographics
NPI:1285968602
Name:HAMM,, JUDITH (ARNP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:HAMM,
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:HAMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:19 BENTWATER CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-7603
Mailing Address - Country:US
Mailing Address - Phone:561-434-9261
Mailing Address - Fax:561-963-5682
Practice Address - Street 1:19 BENTWATER CIR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-7603
Practice Address - Country:US
Practice Address - Phone:561-434-9261
Practice Address - Fax:561-963-5682
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3154922364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3878OtherMEDICARE PROVIDER NUMBER