Provider Demographics
NPI:1770984106
Name:HAMPSON, NATHANIEL STERLING (CPO/LPO)
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:STERLING
Last Name:HAMPSON
Suffix:
Gender:M
Credentials:CPO/LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 PELICAN BAY CT
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32408-7053
Mailing Address - Country:US
Mailing Address - Phone:850-774-6985
Mailing Address - Fax:
Practice Address - Street 1:2425 PELICAN BAY CT
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32408-7053
Practice Address - Country:US
Practice Address - Phone:850-774-6985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR126222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist