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General NPI Number Information
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NPI Number | 1376096024
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Entity Type | Individual
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Provider Name | CONNIE HAMMOND
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Gender | Female
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Dates
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Enumeration Date | 07/29/2016
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Last Update Date | 10/29/2021
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Provider Practice Location Address
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Address Line | 7615 W THUNDERBIRD RD STE 106
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City | PEORIA
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State | AZ
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Zip | 85381-6083
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Country | US
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Telephone | 623-547-6838
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Fax |
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Provider Business Mailing Address
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Address Line | 7615 W THUNDERBIRD RD STE 106
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City | PEORIA
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State | AZ
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Zip | 85381-6083
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Country | US
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Telephone | 623-547-6838
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP8713
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | AP8713
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | AP8713
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License Number State | AZ
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