Healthcare Provider Details

I. General information

NPI: 1871384560
Provider Name (Legal Business Name): LASHENA MICHELE HAMPTON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 STONEYBROOKE WAY
MONTGOMERY AL
36117-6094
US

IV. Provider business mailing address

401 STONEYBROOKE WAY
MONTGOMERY AL
36117-6094
US

V. Phone/Fax

Practice location:
  • Phone: 334-220-5854
  • Fax: 334-220-5854
Mailing address:
  • Phone: 334-220-5854
  • Fax: 334-220-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1-112151
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: