Provider Demographics
NPI:1518340777
Name:HAMMETT, KELLY (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:
Last Name:HAMMETT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 S THREE NOTCH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-5310
Mailing Address - Country:US
Mailing Address - Phone:888-681-5864
Mailing Address - Fax:334-222-6633
Practice Address - Street 1:822 S THREE NOTCH ST
Practice Address - Street 2:SUITE B
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5310
Practice Address - Country:US
Practice Address - Phone:888-681-5864
Practice Address - Fax:334-222-6633
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-134190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily