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General NPI Number Information
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NPI Number | 1639943764
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Entity Type | Individual
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Provider Name | JEFFERY ADAM HEMPHILL FNP-C
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Gender | Male
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Dates
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Enumeration Date | 11/09/2023
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 14 JOHN MADDOX DR NW
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City | ROME
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State | GA
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Zip | 30165-1450
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Country | US
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Telephone | 256-605-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 528 COUNTY ROAD 514
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City | RAINSVILLE
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State | AL
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Zip | 35986-4133
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Country | US
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Telephone | 256-605-4343
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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 | 1-123660
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1-123660
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | GAA-NP001855
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License Number State | GA
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