Provider Demographics
NPI:1093071110
Name:HAMPTON, DREW A (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DREW
Middle Name:A
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 ENTERPRISE BLVD
Mailing Address - Street 2:CREDENTIALS DEPT
Mailing Address - City:ALLENWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:17810-9260
Mailing Address - Country:US
Mailing Address - Phone:570-538-2613
Mailing Address - Fax:
Practice Address - Street 1:66 ENTERPRISE BLVD
Practice Address - Street 2:
Practice Address - City:ALLENWOOD
Practice Address - State:PA
Practice Address - Zip Code:17810-9260
Practice Address - Country:US
Practice Address - Phone:570-538-2613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN584591367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered