Provider Demographics
NPI:1992395008
Name:HAMPTON, JAIME (CPNP-PC, FNP-C)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:CPNP-PC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2429 DATE DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65571-8275
Mailing Address - Country:US
Mailing Address - Phone:417-247-7576
Mailing Address - Fax:
Practice Address - Street 1:110 S 2ND ST
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:MO
Practice Address - Zip Code:63638-9400
Practice Address - Country:US
Practice Address - Phone:573-663-2313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO151400163W00000X
MO2017002550363LP0200X
MO2020032339363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics