Provider Demographics
NPI:1699215053
Name:HAMPTON, DANETTE (LPN)
Entity Type:Individual
Prefix:
First Name:DANETTE
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4264 DEACON CT SW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-3752
Mailing Address - Country:US
Mailing Address - Phone:704-743-8607
Mailing Address - Fax:
Practice Address - Street 1:4264 DEACON CT SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-3752
Practice Address - Country:US
Practice Address - Phone:704-743-8607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC66831164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse