Provider Demographics
NPI:1881910859
Name:HAMMOND, LYDIA MARIE (PMHNP-BC, CNM)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:MARIE
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:PMHNP-BC, CNM
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:MARIE
Other - Last Name:WATTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5035 COPPER BAR RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-9391
Mailing Address - Country:US
Mailing Address - Phone:520-329-2341
Mailing Address - Fax:680-766-1757
Practice Address - Street 1:5035 COPPER BAR RD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-9391
Practice Address - Country:US
Practice Address - Phone:520-329-2341
Practice Address - Fax:680-766-1757
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ301718363LP0808X
OR201250153NP363LP0808X, 367A00000X
AZAP3631363LX0001X, 367A00000X
NM814367A00000X
NM65450363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife