Provider Demographics
NPI:1457724478
Name:HAMMES, COURTNEY JUSTINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JUSTINE
Last Name:HAMMES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 N WINDSONG DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-2248
Mailing Address - Country:US
Mailing Address - Phone:928-772-1613
Mailing Address - Fax:
Practice Address - Street 1:3025 N WINDSONG DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2248
Practice Address - Country:US
Practice Address - Phone:928-772-1613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021664183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist