Provider Demographics
NPI:1255087474
Name:HAMPTON, SHELLY DAWN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:DAWN
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:DAWN SATTERFIELD
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13704 WALSH AVE
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-1909
Mailing Address - Country:US
Mailing Address - Phone:210-542-0752
Mailing Address - Fax:
Practice Address - Street 1:220 SW WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-4714
Practice Address - Country:US
Practice Address - Phone:817-447-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060753363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily