# TRI STATE NEPHROLOGY PSC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TRI STATE NEPHROLOGY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215085170
- **Authorized official:** DONALD N HAMMONDS JR. DO (PRESIDENT)
- **Authorized official phone:** (606) 329-9335

## Contact information

- **Practice address:** 432 16TH ST, SUITE B, ASHLAND, KY 41101-7693
- **Practice address phone:** (606) 329-9335
- **Practice address fax:** (606) 324-6383
- **Mailing address:** PO BOX 2468, ASHLAND, KY 41105-2468
- **Mailing address phone:** (606) 329-9335
- **Mailing address fax:** (606) 324-6383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 4797P | KY | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 06/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 78902582 | — | KY |