Provider Demographics
NPI:1619305042
Name:HAMMOND, MARYANNE (RN)
Entity Type:Individual
Prefix:
First Name:MARYANNE
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SILVER CLIFF
Mailing Address - State:CO
Mailing Address - Zip Code:81252-8581
Mailing Address - Country:US
Mailing Address - Phone:719-783-4401
Mailing Address - Fax:719-783-4402
Practice Address - Street 1:30 MAIN ST
Practice Address - Street 2:
Practice Address - City:SILVER CLIFF
Practice Address - State:CO
Practice Address - Zip Code:81252-8581
Practice Address - Country:US
Practice Address - Phone:719-783-4401
Practice Address - Fax:719-783-4402
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10C356376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84-1315157OtherSTATE OF COLORADO