Healthcare Provider Details

I. General information

NPI: 1215921325
Provider Name (Legal Business Name): CYNTHIA R HAMMOND APRN DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 R ST
LINCOLN NE
68503-3723
US

IV. Provider business mailing address

4545 R ST
LINCOLN NE
68503-3723
US

V. Phone/Fax

Practice location:
  • Phone: 402-465-4545
  • Fax: 402-465-3621
Mailing address:
  • Phone: 402-465-4545
  • Fax: 402-465-3621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number110560
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number110560
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: