Provider Demographics
NPI:1144975962
Name:HAMPTON, CANDICE Y
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:Y
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31503-0938
Mailing Address - Country:US
Mailing Address - Phone:912-937-8680
Mailing Address - Fax:
Practice Address - Street 1:3940 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31503-0938
Practice Address - Country:US
Practice Address - Phone:912-937-8680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No174400000XOther Service ProvidersSpecialist
No1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder