Healthcare Provider Details

I. General information

NPI: 1134795834
Provider Name (Legal Business Name): FAITH HAMILTON MA, PLMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FAITH SHAW

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13460 WALSH DR
BOYS TOWN NE
68010-7529
US

IV. Provider business mailing address

13460 WALSH DR
BOYS TOWN NE
68010-7529
US

V. Phone/Fax

Practice location:
  • Phone: 531-355-3358
  • Fax: 531-355-3375
Mailing address:
  • Phone: 531-355-3358
  • Fax: 531-355-3375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number13858
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: