MEDICARE: STEPHANIE A HAMILTON FNP

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	363LP2300X	Primary Care Nurse Practitioner	516932	TX

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477798064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE A HAMILTON FNP

Provider Business Mailing Address
First Line	:	2000 TEXAS AVE
Second Line	:	200
City	:	TEXAS CITY
State	:	TX
Zip	:	77590-8470
Country	:	US
Telephone Number	:	409-949-3406
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 TEXAS AVE
Second Line	:	200
City	:	TEXAS CITY
State	:	TX
Zip	:	77590-8470
Country	:	US
Telephone Number	:	409-949-3406
Fax Number	:

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

Provider Enumeration Date	:	12/10/2008
Last Update Date	:	12/10/2008

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