MEDICARE: MRS. AMBER HAMM FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	901850	MS

General Provider Information

NPI Number	:	1487196069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMBER HAMM FNP-C

Provider Business Mailing Address
First Line	:	6 COUNTY ROAD 304
Second Line	:
City	:	CORINTH
State	:	MS
Zip	:	38834-8855
Country	:	US
Telephone Number	:	662-643-5866
Fax Number	:

Provider Business Practice Location Address
First Line	:	3196 HIGHWAY 72 W
Second Line	:
City	:	CORINTH
State	:	MS
Zip	:	38834-9303
Country	:	US
Telephone Number	:	662-284-9541
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2016
Last Update Date	:	04/11/2017

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