Healthcare Provider Details

I. General information

NPI: 1083796817
Provider Name (Legal Business Name): REBECCA L HAMPTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3341 S KINGS AVE
SPRINGFIELD MO
65807-5087
US

IV. Provider business mailing address

3341 S KINGS AVE
SPRINGFIELD MO
65807-5087
US

V. Phone/Fax

Practice location:
  • Phone: 417-848-6566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number132195
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: