Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APN0000017080 | TN |
NPI | 1003151168 |
---|---|
Provider Name | Elizabeth Ruth Ann Hampton |
First Address | Hixson, TN 37343-3300 |
Second Address | Hixson, TN 37343-3300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2012 |
Last Update Date | 30/11/2012 |