MEDICARE: MS. FELICIA ASTARTE HAMPTON LPN

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	164W00000X	Licensed Practical Nurse	310129-031	WI

General Provider Information

NPI Number	:	1720214075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FELICIA ASTARTE HAMPTON LPN

Provider Business Mailing Address
First Line	:	300 E MAPLE ST
Second Line	:
City	:	MONTFORT
State	:	WI
Zip	:	53569-9747
Country	:	US
Telephone Number	:	608-574-5095
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E MAPLE ST
Second Line	:
City	:	MONTFORT
State	:	WI
Zip	:	53569-9747
Country	:	US
Telephone Number	:	608-574-5095
Fax Number	:

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

Provider Enumeration Date	:	06/01/2009
Last Update Date	:	06/01/2009

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