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NPI 1003151168

NPI 1003151168 : ELIZABETH RUTH ANN HAMPTON ADULT NURSE PRACTITI : HIXSON, TN

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General NPI Number Information
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    NPI Number           |    1003151168
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    Entity Type          |    Individual 
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    Provider Name        |    ELIZABETH RUTH ANN HAMPTON ADULT NURSE PRACTITI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/30/2012
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    Last Update Date     |    11/30/2012
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Provider Practice Location Address
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    Address Line         |    3000 PRESTON STATION DR 
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    City                 |    HIXSON
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    State                |    TN
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    Zip                  |    37343-3300
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    Country              |    US
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    Telephone            |    423-309-4663
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3000 PRESTON STATION DR 
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    City                 |    HIXSON
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    State                |    TN
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    Zip                  |    37343-3300
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    Country              |    US
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    Telephone            |    423-309-4663
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LA2200X
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    Taxonomy Name        |    Adult Health Nurse Practitioner
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    License Number       |    APN0000017080
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    License Number State |    TN
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