Provider Demographics
NPI:1972140762
Name:HAMPTON, LINDA (SERVICE FACILITATOR)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:SERVICE FACILITATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:AXTON
Mailing Address - State:VA
Mailing Address - Zip Code:24054-0099
Mailing Address - Country:US
Mailing Address - Phone:276-806-9624
Mailing Address - Fax:434-685-1356
Practice Address - Street 1:600 MARTIN DR
Practice Address - Street 2:
Practice Address - City:AXTON
Practice Address - State:VA
Practice Address - Zip Code:24054-3662
Practice Address - Country:US
Practice Address - Phone:276-806-9624
Practice Address - Fax:434-685-1356
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management