Individual
MICHELE DIANE HAMPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18 JOHN WAYNE LN, POWELL, WY 82435-9469
(307) 754-3105
Mailing address
18 JOHN WAYNE LN, POWELL, WY 82435-9469
(307) 754-3105
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000191966160168
KAISER PERMANENTE
CA
01
—
0019196616
KAISER PERMANENTE
CA
01
—
C4998588
DEPARTMENT OF MOTOR VEHICLES
CA
Enumeration date
01/11/2012
Last updated
01/11/2012
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