Provider Demographics
NPI:1003474354
Name:HAMBY, JESSICA LYNN (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LYNN
Last Name:HAMBY
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:HAMBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JUSTUS
Mailing Address - Street 1:158 CATOOSA RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37854-3549
Mailing Address - Country:US
Mailing Address - Phone:865-399-2693
Mailing Address - Fax:
Practice Address - Street 1:80 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6474
Practice Address - Country:US
Practice Address - Phone:865-482-4078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-02
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25928363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ051436Medicaid
TN212152OtherRN LICENSE