Healthcare Provider Details

I. General information

NPI: 1700577442
Provider Name (Legal Business Name): ALAA HAMMOND MSN, RN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N CLARENDON AVE STE 100
AVONDALE ESTATES GA
30002-1150
US

IV. Provider business mailing address

8 N CLARENDON AVE # 100
AVONDALE ESTATES GA
30002-1150
US

V. Phone/Fax

Practice location:
  • Phone: 404-905-6666
  • Fax:
Mailing address:
  • Phone: 404-905-6666
  • Fax: 949-882-9954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704366941
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN296223
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP296223
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: