Provider Demographics
NPI:1548221005
Name:HAMMONS, DONNELL RAE (APRN, CNP)
Entity Type:Individual
Prefix:MRS
First Name:DONNELL
Middle Name:RAE
Last Name:HAMMONS
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:DONNELL
Other - Middle Name:RAE
Other - Last Name:BIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070
Mailing Address - Country:US
Mailing Address - Phone:405-307-6668
Mailing Address - Fax:405-360-6315
Practice Address - Street 1:500 E ROBINSON ST STE 2400
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6684
Practice Address - Country:US
Practice Address - Phone:405-515-0380
Practice Address - Fax:405-307-5632
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0071149363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK363LF0000XOtherNURSE PRACTITIONER FAMILY
OK200015220BMedicaid
OKQ00458Medicare UPIN
OK241406103Medicare ID - Type Unspecified