Provider Demographics
NPI:1992085955
Name:HAMPTON, AMY JEAN
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JEAN
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 CABIN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-8304
Mailing Address - Country:US
Mailing Address - Phone:606-798-6221
Mailing Address - Fax:
Practice Address - Street 1:697 CABIN CREEK RD
Practice Address - Street 2:
Practice Address - City:VANCEBURG
Practice Address - State:KY
Practice Address - Zip Code:41179-8304
Practice Address - Country:US
Practice Address - Phone:606-798-6221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYIECE174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist