Provider Demographics
NPI:1104155183
Name:DEERY, JESSICA HAMMONDS (CRNA)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:HAMMONDS
Last Name:DEERY
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:1946 YOUNG ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2169
Mailing Address - Country:US
Mailing Address - Phone:808-973-7320
Mailing Address - Fax:808-973-7325
Practice Address - Street 1:3288 MOANALUA RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1469
Practice Address - Country:US
Practice Address - Phone:808-432-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-21
Last Update Date:2021-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIRN-66462367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered