Provider Demographics
NPI:1851190334
Name:HAM, TREVOR DOUGLAS
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:DOUGLAS
Last Name:HAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18616 114TH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:NE
Mailing Address - Zip Code:68037-1600
Mailing Address - Country:US
Mailing Address - Phone:402-297-1911
Mailing Address - Fax:
Practice Address - Street 1:18616 114TH ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:NE
Practice Address - Zip Code:68037-1600
Practice Address - Country:US
Practice Address - Phone:402-297-1911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion