Provider Demographics
NPI:1023660461
Name:HAMMOCK, NICOLE (APRN CNP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HAMMOCK
Suffix:
Gender:F
Credentials:APRN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:SOUTH DAYTON ACUTE CARE CONSULTANTS, INC
Mailing Address - Street 2:33 W RAHN RD
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2219
Mailing Address - Country:US
Mailing Address - Phone:937-433-8990
Mailing Address - Fax:937-433-8691
Practice Address - Street 1:SOUTH DAYTON ACUTE CARE CONSULTANTS, INC
Practice Address - Street 2:33 W RAHN RD
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2219
Practice Address - Country:US
Practice Address - Phone:937-433-8990
Practice Address - Fax:937-433-8691
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025122363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner