| Shea Quesenberry Hamm, | |
|
1900 Electric Rd, Salem, VA 24153-7494 | |
| (540) 776-4274 | |
| Not Available |
| Full Name | Shea Quesenberry Hamm |
|---|---|
| Gender | Female |
| Speciality | Registered Nurse |
| Location | 1900 Electric Rd, Salem, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730800434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 001219427 (Virginia) | Primary |
| Entity Name | Wildwood Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629560917 PECOS PAC ID: 1850649310 Enrollment ID: O20180731003816 |
| Entity Name | Kingsford Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871088526 PECOS PAC ID: 0840541017 Enrollment ID: O20180927000385 |
| Mailing Address | Practice Location Address |
|---|---|
| Shea Quesenberry Hamm, 4740 Indian Valley Rd Nw, Willis, VA 24380-4185 Ph: (540) 239-4724 | Shea Quesenberry Hamm, 1900 Electric Rd, Salem, VA 24153-7494 Ph: (540) 776-4274 |
Mrs. Mary Arminta Smith, CRNA Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1970 Roanoke Blvd, Salem, VA 24153 Phone: 540-982-2463 Fax: 540-855-3464 | |
Kyle Sugonis, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1970 Roanoke Blvd, Salem, VA 24153 Phone: 540-982-2463 | |
Amy L Hahn, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1970 Roanoke Blvd, Salem, VA 24153 Phone: 540-982-2463 | |
Brian L Tran, PMHNP-BC Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1970 Roanoke Blvd, Salem, VA 24153 Phone: 540-982-2463 | |
Mr. Ray Andrew Kiracofe Iii, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1970 Roanoke Blvd, Salem, VA 24153 Phone: 540-982-2463 | |
Donna Huff, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1970 Roanoke Blvd, Salem, VA 24153 Phone: 540-982-2463 | |
Mackenzie Brea Wimmer, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1970 Roanoke Blvd, Salem, VA 24153 Phone: 540-982-2463 |