Provider Demographics
NPI:1447429196
Name:HAMMOND, SHARON LYNN (LPN)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LYNN
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 PAMELA DR
Mailing Address - Street 2:
Mailing Address - City:NICHOLS
Mailing Address - State:NY
Mailing Address - Zip Code:13812-3247
Mailing Address - Country:US
Mailing Address - Phone:607-699-6021
Mailing Address - Fax:
Practice Address - Street 1:71 PAMELA DR
Practice Address - Street 2:
Practice Address - City:NICHOLS
Practice Address - State:NY
Practice Address - Zip Code:13812-3247
Practice Address - Country:US
Practice Address - Phone:607-699-6021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226167-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02198387Medicaid