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General NPI Number Information
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NPI Number | 1235791146
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Entity Type | Individual
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Provider Name | JESSI LALENA HAMMOND FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 07/01/2019
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Provider Practice Location Address
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Address Line | 4660 RIVERSIDE PARK BLVD
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City | MACON
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State | GA
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Zip | 31210-1395
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Country | US
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Telephone | 478-405-2373
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Fax | 478-474-5797
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Provider Business Mailing Address
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Address Line | 1779 ROUND OAK JULIETTE RD
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City | JULIETTE
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State | GA
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Zip | 31046-2423
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Country | US
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Telephone | 478-986-8049
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Fax | 478-474-5797
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN199032
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License Number State | GA
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