Provider Demographics
NPI:1639943764
Name:HEMPHILL, JEFFERY ADAM (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:ADAM
Last Name:HEMPHILL
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 COUNTY ROAD 514
Mailing Address - Street 2:
Mailing Address - City:RAINSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35986-4133
Mailing Address - Country:US
Mailing Address - Phone:256-605-4343
Mailing Address - Fax:
Practice Address - Street 1:14 JOHN MADDOX DR NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1450
Practice Address - Country:US
Practice Address - Phone:256-605-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-123660363LF0000X, 363LP2300X
GAGAA-NP001855363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily