Provider Demographics
NPI:1942050299
Name:HAMMITTE, CASHY TIARA (FNP)
Entity Type:Individual
Prefix:
First Name:CASHY
Middle Name:TIARA
Last Name:HAMMITTE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2023
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:MS
Mailing Address - Zip Code:39069-2023
Mailing Address - Country:US
Mailing Address - Phone:404-956-4114
Mailing Address - Fax:
Practice Address - Street 1:232 HAMMETT LN
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:MS
Practice Address - Zip Code:39069-5388
Practice Address - Country:US
Practice Address - Phone:404-956-4114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily