Provider Demographics
NPI:1104838937
Name:HAMMOND, NANCY LYNNE (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LYNNE
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:PHD, LP
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 141408
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-0359
Mailing Address - Country:US
Mailing Address - Phone:651-644-0220
Mailing Address - Fax:651-644-5242
Practice Address - Street 1:2469 UNIVERSITY AVE W
Practice Address - Street 2:SUITE 220 E
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1534
Practice Address - Country:US
Practice Address - Phone:651-644-0220
Practice Address - Fax:651-644-5242
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2856103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical