Provider Demographics
NPI:1336760115
Name:HAMBY, LOIS EILEEN
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:EILEEN
Last Name:HAMBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 DARYL RD
Mailing Address - Street 2:
Mailing Address - City:OLIVER SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37840-3922
Mailing Address - Country:US
Mailing Address - Phone:865-348-5404
Mailing Address - Fax:
Practice Address - Street 1:128 DARYL RD
Practice Address - Street 2:
Practice Address - City:OLIVER SPRINGS
Practice Address - State:TN
Practice Address - Zip Code:37840-3922
Practice Address - Country:US
Practice Address - Phone:865-348-5404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-03
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN79297164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse