Provider Demographics
NPI:1821989757
Name:LANDIS-HAMPTON, EMILY BROOKE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:BROOKE
Last Name:LANDIS-HAMPTON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 S US HIGHWAY 421
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:KY
Mailing Address - Zip Code:40831-2501
Mailing Address - Country:US
Mailing Address - Phone:606-573-9939
Mailing Address - Fax:
Practice Address - Street 1:1540 S US HIGHWAY 421
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:KY
Practice Address - Zip Code:40831-2501
Practice Address - Country:US
Practice Address - Phone:606-573-9939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYF07250101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily