Healthcare Provider Details

I. General information

NPI: 1215623004
Provider Name (Legal Business Name): KASE M HAMM FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 W PARK PL
HENDERSON TN
38340-2027
US

IV. Provider business mailing address

541 W PARK PL
HENDERSON TN
38340-2027
US

V. Phone/Fax

Practice location:
  • Phone: 731-989-1007
  • Fax:
Mailing address:
  • Phone: 731-989-1007
  • Fax: 731-989-0704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0000243232
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number39169
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: