Provider Demographics
NPI:1538513767
Name:HAMMONS, JENNIFER RENEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:RENEE
Last Name:HAMMONS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 HORN BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:WOOLLUM
Mailing Address - State:KY
Mailing Address - Zip Code:40906-8736
Mailing Address - Country:US
Mailing Address - Phone:606-344-0542
Mailing Address - Fax:
Practice Address - Street 1:990 E CUMBERLAND GAP PKWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2574
Practice Address - Country:US
Practice Address - Phone:606-258-7980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY018054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist