Individual
KIAYATTA D HAMPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
24735 S CHESTNUT LN, CRETE, IL 60417-3764
(708) 769-3649
Mailing address
535 E 154TH PL APT 1R, PHOENIX, IL 60426-2682
(708) 890-8749
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043107791
IL
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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