Provider Demographics
NPI:1942764147
Name:HAMPTON, TESLA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TESLA
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:TESLA
Other - Middle Name:
Other - Last Name:KINEMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 6826
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0921
Mailing Address - Country:US
Mailing Address - Phone:304-242-7106
Mailing Address - Fax:304-242-7108
Practice Address - Street 1:3000 GUERNSEY ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:OH
Practice Address - Zip Code:43906-1540
Practice Address - Country:US
Practice Address - Phone:304-633-4765
Practice Address - Fax:740-633-6450
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN87358363LF0000X
OHAPRN.CNP.024110363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily