Healthcare Provider Details

I. General information

NPI: 1073865937
Provider Name (Legal Business Name): FAYE L HAMILTON CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE., ML7009
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE., ML7009
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-3882
  • Fax: 513-636-5454
Mailing address:
  • Phone: 513-636-3882
  • Fax: 513-636-5454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0027344
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number209009851
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: