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General NPI Number Information
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NPI Number | 1104313881
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Entity Type | Individual
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Provider Name | TRACY HAMILTON CCSH/RRT-SDS/RPSGT/R
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Gender | Female
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 04/18/2018
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Provider Practice Location Address
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Address Line | 1845 S GREEN ST
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City | TUPELO
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State | MS
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Zip | 38804-6501
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Country | US
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Telephone | 662-377-3258
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Fax | 662-377-2212
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Provider Business Mailing Address
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Address Line | 1845 S GREEN ST
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City | TUPELO
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State | MS
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Zip | 38804-6501
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Country | US
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Telephone | 662-377-3258
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Fax | 662-377-2212
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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License Number | 6654
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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License Number | 5436
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number | RCP1694
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | RCP1694
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 622
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License Number State | MS
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