Healthcare Provider Details

I. General information

NPI: 1437791464
Provider Name (Legal Business Name): MARGARET MARLETTE HAMILTON AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MEDICAL CENTER DR STE 2550
BRUNSWICK ME
04011-2681
US

IV. Provider business mailing address

104 GREENWOOD RD
BRUNSWICK ME
04011-2946
US

V. Phone/Fax

Practice location:
  • Phone: 207-373-1707
  • Fax:
Mailing address:
  • Phone: 260-615-4456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP191281
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN61448
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: