MEDICARE: MS. KRISTIN M HAMILTON MSPA,.PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	PA1015	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	A0742Y	OTHER	NV	PALMETTO MEDICARE J1

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336396258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTIN M HAMILTON MSPA,.PA-C

Provider Business Mailing Address
First Line	:	3061 S MARYLAND PKWY
Second Line	:	SUITE 200
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-6227
Country	:	US
Telephone Number	:	702-737-1948
Fax Number	:	702-737-7195

Provider Business Practice Location Address
First Line	:	3061 S MARYLAND PKWY
Second Line	:	SUITE 200
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-6227
Country	:	US
Telephone Number	:	702-737-1948
Fax Number	:	702-737-7195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2008
Last Update Date	:	01/05/2010

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Directions to “ MS. KRISTIN M HAMILTON MSPA,.PA-C” Practice Location

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