Provider Demographics
NPI:1366166977
Name:HAMMONS, OLIVIA MICHELLE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MICHELLE
Last Name:HAMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 JUNE ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-3323
Mailing Address - Country:US
Mailing Address - Phone:419-707-3173
Mailing Address - Fax:
Practice Address - Street 1:1207 JUNE ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-3323
Practice Address - Country:US
Practice Address - Phone:419-707-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide