Provider Demographics
NPI:1144520578
Name:HAMMONDS, SHANNON R (FNP-C)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:R
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 59
Mailing Address - Street 2:
Mailing Address - City:TAHOKA
Mailing Address - State:TX
Mailing Address - Zip Code:79373-0059
Mailing Address - Country:US
Mailing Address - Phone:806-561-4322
Mailing Address - Fax:806-905-5922
Practice Address - Street 1:1511 CONWAY ST
Practice Address - Street 2:
Practice Address - City:TAHOKA
Practice Address - State:TX
Practice Address - Zip Code:79373-1110
Practice Address - Country:US
Practice Address - Phone:806-561-4322
Practice Address - Fax:806-905-5922
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX733399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily