Provider Demographics
NPI:1033673215
Name:HAMPTON, SHIMEAKER NICOLE (FULL SPECTRUM DOULA)
Entity Type:Individual
Prefix:
First Name:SHIMEAKER
Middle Name:NICOLE
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:FULL SPECTRUM DOULA
Other - Prefix:
Other - First Name:SHIMEAKER
Other - Middle Name:NICOLE
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5591 DALEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-3435
Mailing Address - Country:US
Mailing Address - Phone:216-301-9956
Mailing Address - Fax:
Practice Address - Street 1:5591 DALEWOOD AVE
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-3435
Practice Address - Country:US
Practice Address - Phone:216-301-9956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNONE374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula