1710124623 NPI number — MRS. CHERYL ANN HAMMOND ASN,RN,CNOR,RNFA

Table of content: MRS. CHERYL ANN HAMMOND ASN,RN,CNOR,RNFA (NPI 1710124623)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710124623 NPI number — MRS. CHERYL ANN HAMMOND ASN,RN,CNOR,RNFA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMMOND
Provider First Name:
CHERYL
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ASN,RN,CNOR,RNFA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LOVELAND
Provider Other First Name:
CHERYL
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPN,ASN,RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1710124623
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47601 GRAND RIVER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NOVI
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48374-1233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-465-3180
Provider Business Mailing Address Fax Number:
248-465-3181

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
47601 GRAND RIVER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NOVI
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48374-1233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-465-3180
Provider Business Practice Location Address Fax Number:
248-465-3181
Provider Enumeration Date:
01/14/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WR0006X , with the licence number:  4704161873 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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