Provider Demographics
NPI:1770809394
Name:HAMMOND, REGINA FAY
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:FAY
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 1:224 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1802
Mailing Address - Country:US
Mailing Address - Phone:615-460-4430
Mailing Address - Fax:615-460-4433
Practice Address - Street 1:224 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1802
Practice Address - Country:US
Practice Address - Phone:615-460-4430
Practice Address - Fax:615-460-4433
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator