Healthcare Provider Details

I. General information

NPI: 1881910859
Provider Name (Legal Business Name): LYDIA MARIE HAMMOND PMHNP-BC, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYDIA MARIE WATTS

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5035 COPPER BAR RD
LAS CRUCES NM
88011-9391
US

IV. Provider business mailing address

5035 COPPER BAR RD
LAS CRUCES NM
88011-9391
US

V. Phone/Fax

Practice location:
  • Phone: 520-329-2341
  • Fax: 680-766-1757
Mailing address:
  • Phone: 520-329-2341
  • Fax: 680-766-1757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number301718
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number201250153NP
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP3631
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number814
License Number StateNM
# 5
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number201250153NP
License Number StateOR
# 6
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP3631
License Number StateAZ
# 7
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number65450
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: