Provider Demographics
NPI:1114762804
Name:HAMPTON, KIMBERLY AMANDA (MPSY, MED, MBA)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:AMANDA
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:MPSY, MED, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116N COUNTY ROAD 440
Mailing Address - Street 2:
Mailing Address - City:MANISTIQUE
Mailing Address - State:MI
Mailing Address - Zip Code:49854-8882
Mailing Address - Country:US
Mailing Address - Phone:906-450-4309
Mailing Address - Fax:
Practice Address - Street 1:1116N COUNTY ROAD 440
Practice Address - Street 2:
Practice Address - City:MANISTIQUE
Practice Address - State:MI
Practice Address - Zip Code:49854-8882
Practice Address - Country:US
Practice Address - Phone:906-450-4309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula