Provider Demographics
NPI:1396335121
Name:HAMPTON, DANA (RN)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1786 N OLYMPIAN WAY SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-2439
Mailing Address - Country:US
Mailing Address - Phone:678-857-6126
Mailing Address - Fax:
Practice Address - Street 1:3750 N HENRY BLVD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3936
Practice Address - Country:US
Practice Address - Phone:770-687-6861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN261731163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy