Provider Demographics
NPI:1982386959
Name:HAMMOND, ELIZABETH DARE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DARE
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6569 QUIET HOURS APT T1
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4996
Mailing Address - Country:US
Mailing Address - Phone:410-322-6244
Mailing Address - Fax:
Practice Address - Street 1:6569 QUIET HOURS APT T1
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4996
Practice Address - Country:US
Practice Address - Phone:410-322-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR179417363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty