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NPI 1598256265

NPI 1598256265 : NICOLE RENEE HAMMOND MD : MATTOON, IL

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General NPI Number Information
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    NPI Number           |    1598256265
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    Entity Type          |    Individual 
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    Provider Name        |    NICOLE RENEE HAMMOND MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/29/2018
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    Last Update Date     |    09/23/2025
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Provider Practice Location Address
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    Address Line         |    1000 HEALTH CENTER DR STE 401 
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    City                 |    MATTOON
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    State                |    IL
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    Zip                  |    61938-4648
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    Country              |    US
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    Telephone            |    217-258-4020
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    Fax                  |    217-258-4023
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Provider Business Mailing Address
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    Address Line         |    PO BOX 372 
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    City                 |    MATTOON
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    State                |    IL
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    Zip                  |    61938-0372
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    Country              |    US
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    Telephone            |    
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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        |    208600000X
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    Taxonomy Name        |    Surgery Physician
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    License Number       |    036-171659
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    208600000X
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    Taxonomy Name        |    Surgery Physician
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    License Number       |    MT215445
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    License Number State |    PA
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