Provider Demographics
NPI:1255503520
Name:HAMMON, CHRISTINA LOUISE
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LOUISE
Last Name:HAMMON
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 1:15783 CANNONS MILL RD
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9711
Mailing Address - Country:US
Mailing Address - Phone:330-385-4153
Mailing Address - Fax:
Practice Address - Street 1:15783 CANNONS MILL RD
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9711
Practice Address - Country:US
Practice Address - Phone:330-385-4153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2740574Medicaid