MEDICARE: MRS. LEIGH A HAMPTON FNP

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	363LF0000X	Family Nurse Practitioner	132414	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083617104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEIGH A HAMPTON FNP

Provider Business Mailing Address
First Line	:	211 SAINT FRANCIS DR
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-5049
Country	:	US
Telephone Number	:	573-331-3000
Fax Number	:	573-331-5016

Provider Business Practice Location Address
First Line	:	211 SAINT FRANCIS DR
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-5049
Country	:	US
Telephone Number	:	573-331-3000
Fax Number	:	573-331-5016

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/12/2015

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