Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 1001635-15 | WI |
Y | 213EG0000X | General Practice | 1001635-15 | WI |
NPI | 1003261462 |
---|---|
Provider Name | Naa Norkor Hammond |
First Address | Appleton, WI 54913-8507 |
Second Address | Appleton, WI 54913-8507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2016 |
Last Update Date | 29/08/2017 |