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General NPI Number Information
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NPI Number | 1467324665
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Entity Type | Individual
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Provider Name | ALYSSA HAMILTON
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Gender | Female
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 3560 S 4TH ST
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City | TERRE HAUTE
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State | IN
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Zip | 47802-5540
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Country | US
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Telephone | 812-235-8496
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Fax |
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Provider Business Mailing Address
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Address Line | 4095 YALE DR
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City | ROCKTON
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State | IL
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Zip | 61072-3209
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Country | US
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Telephone | 815-980-6304
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10005017A
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License Number State | IN
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