Provider Demographics
NPI:1861789240
Name:HAMMOND, JULIE A (CRNA)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:LOMBARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 171306
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38187
Mailing Address - Country:US
Mailing Address - Phone:800-809-2106
Mailing Address - Fax:334-386-2037
Practice Address - Street 1:2704 W OXFORD LOOP
Practice Address - Street 2:SUITE 117
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5714
Practice Address - Country:US
Practice Address - Phone:662-550-4299
Practice Address - Fax:662-580-4324
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR876263367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03902501Medicaid