Provider Demographics
NPI:1588315956
Name:HAMMETT, KRYSTAL RHIANN (CNC)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:RHIANN
Last Name:HAMMETT
Suffix:
Gender:F
Credentials:CNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 W CLAY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-4914
Mailing Address - Country:US
Mailing Address - Phone:713-835-9071
Mailing Address - Fax:
Practice Address - Street 1:1512 W CLAY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-4914
Practice Address - Country:US
Practice Address - Phone:713-835-9071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16H606710133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist