Provider Demographics
NPI:1962740217
Name:HUMMEL, CHRISTIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:HUMMEL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:PO BOX 1210
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38503-1210
Mailing Address - Country:US
Mailing Address - Phone:931-520-1414
Mailing Address - Fax:931-520-1246
Practice Address - Street 1:112 N. WALNUT AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501
Practice Address - Country:US
Practice Address - Phone:931-520-1414
Practice Address - Fax:931-520-1246
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6295363LF0000X
TNAPN6295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily