Healthcare Provider Details

I. General information

NPI: 1093261497
Provider Name (Legal Business Name): SHAUN HAMPTON N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2016
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 S VAL VISTA DR STE 126
MESA AZ
85204-7372
US

IV. Provider business mailing address

1955 S VAL VISTA DR STE 126
MESA AZ
85204-7372
US

V. Phone/Fax

Practice location:
  • Phone: 480-272-8944
  • Fax: 480-237-5672
Mailing address:
  • Phone: 480-272-8944
  • Fax: 623-888-8570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP8927
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: