Provider Demographics
NPI:1194600122
Name:VANDER HAMM, MOLLY
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:VANDER HAMM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 PRIMROSE CT
Mailing Address - Street 2:
Mailing Address - City:HICKMAN
Mailing Address - State:NE
Mailing Address - Zip Code:68372-9485
Mailing Address - Country:US
Mailing Address - Phone:308-383-6757
Mailing Address - Fax:
Practice Address - Street 1:940 PRIMROSE CT
Practice Address - Street 2:
Practice Address - City:HICKMAN
Practice Address - State:NE
Practice Address - Zip Code:68372-9485
Practice Address - Country:US
Practice Address - Phone:308-383-6757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer