Provider Demographics
NPI:1326046707
Name:HAMMOND, ANGELA C (WHNP, APN, MSN)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:C
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:WHNP, APN, MSN
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Mailing Address - Street 1:3810 WINCHESTER RD
Mailing Address - Street 2:SOUTHEAST MENTAL HEALTH CENTER
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-6045
Mailing Address - Country:US
Mailing Address - Phone:901-369-1420
Mailing Address - Fax:901-369-1433
Practice Address - Street 1:2579 DOUGLASS AVE
Practice Address - Street 2:SOUTHEAST MENTAL HEALTH CENTER
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38114-2532
Practice Address - Country:US
Practice Address - Phone:901-369-1480
Practice Address - Fax:901-312-7572
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2008-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN5606363LP0808X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health