Provider Demographics
NPI:1720453798
Name:HAMMOND, TERESITA (RN)
Entity Type:Individual
Prefix:
First Name:TERESITA
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3432 STANCIL ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4206
Mailing Address - Country:US
Mailing Address - Phone:757-679-3979
Mailing Address - Fax:
Practice Address - Street 1:3432 STANCIL ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-4206
Practice Address - Country:US
Practice Address - Phone:757-679-3979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001232843163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse