Provider Demographics
NPI:1366621831
Name:HAMMES, ELAINE M (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:M
Last Name:HAMMES
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16541 210TH ST
Mailing Address - Street 2:
Mailing Address - City:SIGOURNEY
Mailing Address - State:IA
Mailing Address - Zip Code:52591-8132
Mailing Address - Country:US
Mailing Address - Phone:641-660-1603
Mailing Address - Fax:
Practice Address - Street 1:16541 210TH ST
Practice Address - Street 2:
Practice Address - City:SIGOURNEY
Practice Address - State:IA
Practice Address - Zip Code:52591-8132
Practice Address - Country:US
Practice Address - Phone:641-660-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00147133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA17654Medicare PIN