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NPI Code Detail

MEDICARE: DEBORAH JEAN HAMMONS RN WCC

MEDICARE: DEBORAH JEAN HAMMONS RN WCC
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
1163WW0000XWound Care Registered NurseRN 239981OH

General Provider Information

NPI Number : 1952541914
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH JEAN HAMMONS RN WCC
Provider Business Mailing Address
First Line : 307 MAIN ST
Second Line : PO BOX 362
City : BRINKHAVEN
State : OH
Zip : 43006
Country : US
Telephone Number : 740-507-4704
Fax Number :
Provider Business Practice Location Address
First Line : 1558 COSHOCTON AVE
Second Line : PMB 111
City : MOUNT VERNON
State : OH
Zip : 43050-5416
Country : US
Telephone Number : 740-507-4704
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2009
Last Update Date : 03/03/2009

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