MEDICARE: MELONYE LASCHELLE HAMPTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	0088591	OK

General Provider Information

NPI Number	:	1194495226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELONYE LASCHELLE HAMPTON

Provider Business Mailing Address
First Line	:	6617 LAUREL RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-6741
Country	:	US
Telephone Number	:	405-968-1385
Fax Number	:

Provider Business Practice Location Address
First Line	:	6617 LAUREL RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-6741
Country	:	US
Telephone Number	:	405-968-1385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2021
Last Update Date	:	09/20/2021

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Directions to “ MELONYE LASCHELLE HAMPTON ” Practice Location

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