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General NPI Number Information
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NPI Number | 1598305047
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Entity Type | Individual
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Provider Name | THELMA ROSE HAMPTON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 145 NEWCOMB AVE
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City | MOUNT VERNON
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State | KY
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Zip | 40456-2728
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Country | US
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Telephone | 606-256-2195
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Fax |
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Provider Business Mailing Address
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Address Line | 266 WILDWOOD AVE
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City | LONDON
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State | KY
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Zip | 40744-9158
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Country | US
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Telephone | 606-224-2798
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3014112
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License Number State | KY
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