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NPI Code Detail

MEDICARE: DAYNA HAMM PRIDGEN FNP

MEDICARE: DAYNA HAMM PRIDGEN FNP
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
1363LF0000XFamily Nurse Practitioner881108MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649689548
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAYNA HAMM PRIDGEN FNP
Provider Business Mailing Address
First Line : PO BOX 291
Second Line :
City : TAYLORSVILLE
State : MS
Zip : 39168-0291
Country : US
Telephone Number : 601-705-2897
Fax Number : 601-579-5240
Provider Business Practice Location Address
First Line : 1050 SW 6TH AVE STE 1100
Second Line :
City : PORTLAND
State : OR
Zip : 97204-1153
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2014
Last Update Date : 04/28/2025

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