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General NPI Number Information
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NPI Number | 1477919520
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Entity Type | Individual
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Provider Name | MISTY DAWN HAMMOND FNP
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Gender | Female
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 7557 DANNAHER DR STE G20
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City | POWELL
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State | TN
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Zip | 37849-1517
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Country | US
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Telephone | 865-524-2547
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Fax |
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Provider Business Mailing Address
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Address Line | 7557 DANNAHER DR STE G20
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City | POWELL
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State | TN
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Zip | 37849-1517
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Country | US
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Telephone | 865-524-2547
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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 | 209013758
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26614
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License Number State | TN
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