Provider Demographics
NPI:1275923948
Name:MCKINNEY-HAMMOCK, DAWN (AG/ACNP-BC, CCRN)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:
Last Name:MCKINNEY-HAMMOCK
Suffix:
Gender:F
Credentials:AG/ACNP-BC, CCRN
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:MCKINNEY
Other - Last Name:HAMMOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AG/ACNP-BC, CCRN
Mailing Address - Street 1:404 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-5427
Mailing Address - Country:US
Mailing Address - Phone:713-304-2852
Mailing Address - Fax:
Practice Address - Street 1:404 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-5427
Practice Address - Country:US
Practice Address - Phone:713-304-2852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX582713363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care