Provider Demographics
NPI:1245999457
Name:HAMMONDS, ALYSSA LAUREN-OLIVIA (RD)
Entity type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:LAUREN-OLIVIA
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164-1429
Mailing Address - Country:US
Mailing Address - Phone:270-237-4423
Mailing Address - Fax:270-237-4777
Practice Address - Street 1:107 N COURT ST
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164-1429
Practice Address - Country:US
Practice Address - Phone:270-237-4423
Practice Address - Fax:270-237-4777
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY272308133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered