Provider Demographics
NPI:1063738334
Name:HAMPTON, SHIRLEY ANN (REG NURSE)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:ANN
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:REG NURSE
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:REG NURSE
Mailing Address - Street 1:4467 NIOBE CIR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-8044
Mailing Address - Country:US
Mailing Address - Phone:916-434-7698
Mailing Address - Fax:
Practice Address - Street 1:4467 NIOBE CIR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-8044
Practice Address - Country:US
Practice Address - Phone:916-434-7698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA352742163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse