Healthcare Provider Details

I. General information

NPI: 1285341180
Provider Name (Legal Business Name): DR. BENNYCE EDNA HAMILTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2022
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 KINNEY AVE
MOUNT HEALTHY OH
45231-4275
US

IV. Provider business mailing address

6708 DEVONWOOD DR
CINCINNATI OH
45224-1116
US

V. Phone/Fax

Practice location:
  • Phone: 513-218-3068
  • Fax:
Mailing address:
  • Phone: 513-218-3068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number31225
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: