Provider Demographics
NPI:1346648706
Name:HAMBY, ELLEN HAMM (CRNP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:HAMM
Last Name:HAMBY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 LIBERTY PKWY STE 114
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7563
Mailing Address - Country:US
Mailing Address - Phone:205-968-5988
Mailing Address - Fax:
Practice Address - Street 1:8000 LIBERTY PKWY STE 114
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35242-7563
Practice Address - Country:US
Practice Address - Phone:205-968-5988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-130879363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care