Basic Information
| Provider Information | |||||||||
| NPI: | 1023660461 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMMOCK | ||||||||
| FirstName: | NICOLE | ||||||||
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| Credential: | APRN CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | SOUTH DAYTON ACUTE CARE CONSULTANTS, INC | ||||||||
| Address2: | 33 W RAHN RD | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454292219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374338990 | ||||||||
| FaxNumber: | 9374338691 | ||||||||
| Practice Location | |||||||||
| Address1: | SOUTH DAYTON ACUTE CARE CONSULTANTS, INC | ||||||||
| Address2: | 33 W RAHN RD | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454292219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374338990 | ||||||||
| FaxNumber: | 9374338691 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2019 | ||||||||
| LastUpdateDate: | 07/16/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN.CNP.025122 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.