Provider Demographics
NPI:1518398999
Name:HAMMONS, REXANN (LPN)
Entity Type:Individual
Prefix:
First Name:REXANN
Middle Name:
Last Name:HAMMONS
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 1:605 W BRIAR LN
Mailing Address - Street 2:APT 223
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-1367
Mailing Address - Country:US
Mailing Address - Phone:920-569-9911
Mailing Address - Fax:
Practice Address - Street 1:605 W BRIAR LN
Practice Address - Street 2:APT 223
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-1367
Practice Address - Country:US
Practice Address - Phone:920-569-9911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI316896-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse