Provider Demographics
NPI:1740716349
Name:HAMMEL, KASEY LEIGH (NP-C)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:LEIGH
Last Name:HAMMEL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 PAOLI PIKE
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-5100
Mailing Address - Country:US
Mailing Address - Phone:812-945-4844
Mailing Address - Fax:
Practice Address - Street 1:2708 PAOLI PIKE
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-5100
Practice Address - Country:US
Practice Address - Phone:812-945-4844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011290363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily