Provider Demographics
NPI:1902434665
Name:HAMMAN, EVELYN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:HAMMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13802 MOOSEHEAD CIR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34669-3920
Mailing Address - Country:US
Mailing Address - Phone:813-817-8357
Mailing Address - Fax:
Practice Address - Street 1:13802 MOOSEHEAD CIR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34669-3920
Practice Address - Country:US
Practice Address - Phone:813-817-8357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN10006781363L00000X
FLAPRN11006781363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty