MEDICARE: KENISHA HAMPTON MANUEL FNP-C

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	208448	LA

General Provider Information

NPI Number	:	1477188738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENISHA HAMPTON MANUEL FNP-C

Provider Business Mailing Address
First Line	:	11 SAINT LOUPE DR
Second Line	:
City	:	LA PLACE
State	:	LA
Zip	:	70068-6492
Country	:	US
Telephone Number	:	504-957-2194
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 SEVERN AVE STE 450
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70001-6950
Country	:	US
Telephone Number	:	504-325-2528
Fax Number	:

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

Provider Enumeration Date	:	03/06/2020
Last Update Date	:	02/04/2026

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