Healthcare Provider Details

I. General information

NPI: 1801415203
Provider Name (Legal Business Name): LAURA DIANN HAMILTON TRADITIONAL MIDWIFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17853 SW MEADOWLARK RD
ROSE HILL KS
67133-8186
US

IV. Provider business mailing address

17853 SW MEADOWLARK RD
ROSE HILL KS
67133-8186
US

V. Phone/Fax

Practice location:
  • Phone: 405-439-4191
  • Fax:
Mailing address:
  • Phone: 405-439-4191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: