Provider Demographics
NPI:1841078912
Name:HAMON, TAMMY SUE (FNP)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:SUE
Last Name:HAMON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 ALLAN ADALE DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-8224
Mailing Address - Country:US
Mailing Address - Phone:209-404-3474
Mailing Address - Fax:
Practice Address - Street 1:3221 ALLAN ADALE DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-8224
Practice Address - Country:US
Practice Address - Phone:209-404-3474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily