Healthcare Provider Details

I. General information

NPI: 1932023389
Provider Name (Legal Business Name): TIFFANY RENEE HAMMER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8881 N MAIN ST
DAYTON OH
45415-1333
US

IV. Provider business mailing address

1235 RIVERBEND BLVD
SIDNEY OH
45365-2233
US

V. Phone/Fax

Practice location:
  • Phone: 937-293-1622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0043395
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: