Provider Demographics
NPI:1093116196
Name:HAMILTON, DIANE E (RNC)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:E
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27072 CARRONADE DR STE ABC
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5300
Mailing Address - Country:US
Mailing Address - Phone:419-352-5387
Mailing Address - Fax:419-352-6033
Practice Address - Street 1:27072 CARRONADE DR STE ABC
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5300
Practice Address - Country:US
Practice Address - Phone:419-352-5387
Practice Address - Fax:419-352-6033
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN189765163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health