Provider Demographics
NPI:1073906830
Name:HAMILTON, ANNEKA (LVN)
Entity Type:Individual
Prefix:MS
First Name:ANNEKA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 OAKDALE RD APT 138
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-2693
Mailing Address - Country:US
Mailing Address - Phone:209-551-1126
Mailing Address - Fax:
Practice Address - Street 1:2300 OAKDALE RD APT 138
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2693
Practice Address - Country:US
Practice Address - Phone:209-551-1126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA221530164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse