MEDICARE: KELSIE HAMMONS 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	4002751	KY

General Provider Information

NPI Number	:	1902722960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSIE HAMMONS FNP-C

Provider Business Mailing Address
First Line	:	250 SWAIN RD
Second Line	:
City	:	PINE KNOT
State	:	KY
Zip	:	42635-9140
Country	:	US
Telephone Number	:	606-310-3522
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 N HIGHWAY 27
Second Line	:
City	:	WHITLEY CITY
State	:	KY
Zip	:	42653-4112
Country	:	US
Telephone Number	:	606-376-5391
Fax Number	:

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

Provider Enumeration Date	:	06/25/2026
Last Update Date	:	06/25/2026

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Directions to “ KELSIE HAMMONS FNP-C” Practice Location

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