Provider Demographics
NPI:1942070404
Name:HAMMOND, OPAL NICHOL
Entity Type:Individual
Prefix:
First Name:OPAL
Middle Name:NICHOL
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6346 STATE ROUTE 220
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-9046
Mailing Address - Country:US
Mailing Address - Phone:740-977-7598
Mailing Address - Fax:
Practice Address - Street 1:2710 SHYVILLE RD APT 7B
Practice Address - Street 2:
Practice Address - City:PIKETON
Practice Address - State:OH
Practice Address - Zip Code:45661-9806
Practice Address - Country:US
Practice Address - Phone:740-648-8227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant