Basic Information
Provider Information
NPI: 1497235998
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMMONDS
FirstName: AMANDA
MiddleName: ALAFAIR
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 305 CLAIREMONT DR
Address2:  
City: EL PASO
State: TX
PostalCode: 799125348
CountryCode: US
TelephoneNumber: 9155496576
FaxNumber:  
Practice Location
Address1: 7400 VISCOUNT BLVD
Address2:  
City: EL PASO
State: TX
PostalCode: 799254828
CountryCode: US
TelephoneNumber: 9156299260
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/15/2018
LastUpdateDate: 08/15/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X771181TXY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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