Provider Demographics
NPI:1215642459
Name:HAMM, LILLIAN KENDALL (APRN)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:KENDALL
Last Name:HAMM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1080
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-1080
Mailing Address - Country:US
Mailing Address - Phone:270-864-1472
Mailing Address - Fax:270-864-1693
Practice Address - Street 1:197 WILL WALKER RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-7436
Practice Address - Country:US
Practice Address - Phone:270-384-9981
Practice Address - Fax:270-384-9989
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN266159163W00000X
KY4026971363LF0000X
NC5018722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse