Provider Demographics
NPI:1255713947
Name:HAMPTON, JENEEN PATRICE
Entity type:Individual
Prefix:MS
First Name:JENEEN
Middle Name:PATRICE
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29032 LEROY ST
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-4900
Mailing Address - Country:US
Mailing Address - Phone:313-815-7324
Mailing Address - Fax:
Practice Address - Street 1:29032 LEROY ST
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-4900
Practice Address - Country:US
Practice Address - Phone:313-815-7324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other