Provider Demographics
NPI:1467150011
Name:HAMPTON, ANGEL (APRN)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 RAGIS RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32132-2905
Mailing Address - Country:US
Mailing Address - Phone:386-679-3614
Mailing Address - Fax:
Practice Address - Street 1:2975 RAGIS RD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32132-2905
Practice Address - Country:US
Practice Address - Phone:386-679-3614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily