Provider Demographics
NPI:1073877528
Name:HAMRICK, ELLEN (PNP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:HAMRICK
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 MT VERNON HWY
Mailing Address - Street 2:SUITE 460
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4274
Mailing Address - Country:US
Mailing Address - Phone:404-252-7900
Mailing Address - Fax:404-252-7905
Practice Address - Street 1:755 MT VERNON HWY
Practice Address - Street 2:SUITE 460
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4274
Practice Address - Country:US
Practice Address - Phone:404-252-7900
Practice Address - Fax:404-252-7905
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN159447363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics