Provider Demographics
NPI:1093376832
Name:HAMMONDS, KIMBERLY ANNE (DNP, RN, PMHNP)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANNE
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:DNP, RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 514
Mailing Address - Street 2:
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:64850-0514
Mailing Address - Country:US
Mailing Address - Phone:417-592-1667
Mailing Address - Fax:
Practice Address - Street 1:2000 CENTER POINT DRIVE
Practice Address - Street 2:SUITE 2350
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27642363LP0808X
MO2019022617363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health