Provider Demographics
NPI:1164725495
Name:HAMILTON, BONNIE W (RN)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:W
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:NY
Mailing Address - Zip Code:13753-1221
Mailing Address - Country:US
Mailing Address - Phone:607-832-5200
Mailing Address - Fax:607-832-5201
Practice Address - Street 1:99 MAIN ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:NY
Practice Address - Zip Code:13753-1221
Practice Address - Country:US
Practice Address - Phone:607-832-5200
Practice Address - Fax:607-832-5201
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290791-1163WA2000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management