Healthcare Provider Details
I. General information
NPI: 1932472354
Provider Name (Legal Business Name): CHRISTY M HAMILTON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/15/2012
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1211 WILMINGTON AVE
NEW CASTLE PA
16105-2516
US
IV. Provider business mailing address
5500 MARKET ST SUITE 119
BOARDMAN OH
44512-2601
US
V. Phone/Fax
- Phone: 724-824-4096
- Fax: 724-269-9476
- Phone: 724-824-4096
- Fax: 724-269-9476
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN562414 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | 088428 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: