Provider Demographics
NPI:1679233191
Name:HAMPTON, BREANNA LYNN (NP)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:LYNN
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4190
Mailing Address - Country:US
Mailing Address - Phone:563-344-2240
Mailing Address - Fax:563-362-3059
Practice Address - Street 1:865 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4190
Practice Address - Country:US
Practice Address - Phone:563-344-2240
Practice Address - Fax:563-362-3059
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAA166765363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner