Provider Demographics
NPI:1336372986
Name:HAMPTON, TAMMY DENISE (LPN)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:DENISE
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:D
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:7947 JOHNSON ST APT 11
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6847
Mailing Address - Country:US
Mailing Address - Phone:954-549-9564
Mailing Address - Fax:
Practice Address - Street 1:7947 JOHNSON ST
Practice Address - Street 2:SUITE # 11-A
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6847
Practice Address - Country:US
Practice Address - Phone:954-549-3547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN 5154215164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018479000Medicaid