Provider Demographics
NPI:1689970477
Name:HEMPHILL, JENNIFER DIANE (APRN-C)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:DIANE
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
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Mailing Address - Street 1:1816 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-4058
Mailing Address - Country:US
Mailing Address - Phone:785-760-4434
Mailing Address - Fax:785-760-4434
Practice Address - Street 1:390 LIMIT ST
Practice Address - Street 2:MINUTE CLINIC
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-4525
Practice Address - Country:US
Practice Address - Phone:785-760-4434
Practice Address - Fax:785-760-4434
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS75169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200321860AMedicaid
KS200750060AMedicaid