MEDICARE: MAKAYLA KENIKE HAMPTON-BARNETT

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	2017023309	MO

General Provider Information

NPI Number	:	1477361343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKAYLA KENIKE HAMPTON-BARNETT

Provider Business Mailing Address
First Line	:	3461 CHIPPEWA DR
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62221-3516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3461 CHIPPEWA DR
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62221-3516
Country	:	US
Telephone Number	:	618-567-0139
Fax Number	:

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

Provider Enumeration Date	:	12/24/2024
Last Update Date	:	12/04/2025

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Directions to “ MAKAYLA KENIKE HAMPTON-BARNETT ” Practice Location

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