Provider Demographics
NPI:1134146699
Name:HAMILTON, CHANSE (RN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHANSE
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 NAPA DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3921
Mailing Address - Country:US
Mailing Address - Phone:361-992-9487
Mailing Address - Fax:
Practice Address - Street 1:5950 SARATOGA BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4100
Practice Address - Country:US
Practice Address - Phone:361-985-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX650507363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner