Provider Demographics
NPI:1780234484
Name:HAMEL, STEPHANIE JULIENNE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JULIENNE
Last Name:HAMEL
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 1:1401 MARKET ST APT 501
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-4495
Mailing Address - Country:US
Mailing Address - Phone:423-903-0081
Mailing Address - Fax:
Practice Address - Street 1:119 WHITE WATER DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:TN
Practice Address - Zip Code:37361-3645
Practice Address - Country:US
Practice Address - Phone:423-299-9435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-14
Last Update Date:2019-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000026171363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care