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NPI Code Detail

MEDICARE: VICKI DAWN HAMMONS APRN (STUDENT)

MEDICARE: VICKI DAWN HAMMONS APRN (STUDENT)
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WE0003XEmergency Registered Nurse66643OK
2363LF0000XFamily Nurse Practitioner66643OK

General Provider Information

NPI Number : 1619452372
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI DAWN HAMMONS APRN (STUDENT)
Provider Business Mailing Address
First Line : 14502 S TOLEDO PL
Second Line :
City : BIXBY
State : OK
Zip : 74008-8016
Country : US
Telephone Number : 918-724-5793
Fax Number :
Provider Business Practice Location Address
First Line : 20 E 34TH ST
Second Line :
City : SAND SPRINGS
State : OK
Zip : 74063-4001
Country : US
Telephone Number : 918-245-9675
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2018
Last Update Date : 04/01/2019

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Directions to “ VICKI DAWN HAMMONS APRN (STUDENT)” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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