Provider Demographics
NPI:1134264666
Name:HAMMOND, TAMMY JO (STNA STATE TESTED NU)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:JO
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:STNA STATE TESTED NU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EAST WILLIAM STREET
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015
Mailing Address - Country:US
Mailing Address - Phone:740-363-3103
Mailing Address - Fax:
Practice Address - Street 1:2178 BRUCE RD
Practice Address - Street 2:APPT #101
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015
Practice Address - Country:US
Practice Address - Phone:740-363-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered374U00000XNursing Service Related ProvidersHome Health Aide
Not Answered376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2225256OtherPROVIDER NUMBER
2225256Medicare UPIN