Provider Demographics
NPI:1720214075
Name:HAMPTON, FELICIA ASTARTE (LPN)
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:ASTARTE
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 1:300 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MONTFORT
Mailing Address - State:WI
Mailing Address - Zip Code:53569-9747
Mailing Address - Country:US
Mailing Address - Phone:608-574-5095
Mailing Address - Fax:
Practice Address - Street 1:300 E MAPLE ST
Practice Address - Street 2:
Practice Address - City:MONTFORT
Practice Address - State:WI
Practice Address - Zip Code:53569-9747
Practice Address - Country:US
Practice Address - Phone:608-574-5095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI310129-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse