Healthcare Provider Details

I. General information

NPI: 1700484631
Provider Name (Legal Business Name): DANA MARIE HAMPTON DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2474 SW PERKINS AVE
PENDLETON OR
97801-4302
US

IV. Provider business mailing address

PO BOX 143
ECHO OR
97826-0143
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-1700
  • Fax:
Mailing address:
  • Phone: 541-571-2465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number202008125NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: