Provider Demographics
NPI:1871075515
Name:HAMMILL, NANCY ANN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:HAMMILL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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 81
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848-0081
Mailing Address - Country:US
Mailing Address - Phone:862-268-4609
Mailing Address - Fax:
Practice Address - Street 1:22 BEAVER RUN RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:NJ
Practice Address - Zip Code:07848-3115
Practice Address - Country:US
Practice Address - Phone:862-268-4609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00528100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist