Provider Demographics
NPI:1134480627
Name:HAMPTON, ANISHA MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:ANISHA
Middle Name:MICHELLE
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3641 LYNNFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5111
Mailing Address - Country:US
Mailing Address - Phone:216-394-2046
Mailing Address - Fax:
Practice Address - Street 1:3641 LYNNFIELD RD
Practice Address - Street 2:
Practice Address - City:SHAKER HTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5111
Practice Address - Country:US
Practice Address - Phone:216-394-2046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.353851163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse