Provider Demographics
NPI:1659090488
Name:HAMPTON, KALA L
Entity Type:Individual
Prefix:
First Name:KALA
Middle Name:L
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26397 BRUSH AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3215
Mailing Address - Country:US
Mailing Address - Phone:216-203-5859
Mailing Address - Fax:
Practice Address - Street 1:26397 BRUSH AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3215
Practice Address - Country:US
Practice Address - Phone:216-203-5859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty