Provider Demographics
NPI:1609429349
Name:HAMMOND, HEATHER NICOLE (APRN FNP-BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:NICOLE
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 MALLORYSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TIGNALL
Mailing Address - State:GA
Mailing Address - Zip Code:30668-1586
Mailing Address - Country:US
Mailing Address - Phone:706-401-2332
Mailing Address - Fax:
Practice Address - Street 1:1113 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-7523
Practice Address - Country:US
Practice Address - Phone:706-595-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN210511363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily