Healthcare Provider Details

I. General information

NPI: 1710452750
Provider Name (Legal Business Name): CYNTHIA HAMILTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA M HARDIN HAMILTON

II. Dates (important events)

Enumeration Date: 10/05/2018
Last Update Date: 10/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 TUTT BLVD STE 100
COLORADO SPRINGS CO
80923-3503
US

IV. Provider business mailing address

7353 SISTERS GRV
COLORADO SPRINGS CO
80923-2615
US

V. Phone/Fax

Practice location:
  • Phone: 719-473-2346
  • Fax: 719-577-9627
Mailing address:
  • Phone: 719-444-8484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN00994206
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: