Healthcare Provider Details

I. General information

NPI: 1154323145
Provider Name (Legal Business Name): CRYSTAL R HAMMOND APRN-CNM, APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 VESTER AVE
SPRINGFIELD OH
45503-1302
US

IV. Provider business mailing address

2929 SHRINE RD
SPRINGFIELD OH
45502-9020
US

V. Phone/Fax

Practice location:
  • Phone: 937-399-7100
  • Fax:
Mailing address:
  • Phone: 937-964-1268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRNCNP020368
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRNCNP020368
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRNCNM03296
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: