Provider Demographics
NPI:1225674179
Name:HAMLETTE, ANTONIO SEYMOUR (FNP)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:SEYMOUR
Last Name:HAMLETTE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:ANTONIO
Other - Middle Name:S
Other - Last Name:HAMLETTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:7515 WILLIAMSON RD
Mailing Address - Street 2:
Mailing Address - City:HOLLINS
Mailing Address - State:VA
Mailing Address - Zip Code:24019-4301
Mailing Address - Country:US
Mailing Address - Phone:434-941-9459
Mailing Address - Fax:
Practice Address - Street 1:7515 WILLIAMSON RD
Practice Address - Street 2:
Practice Address - City:HOLLINS
Practice Address - State:VA
Practice Address - Zip Code:24019-4301
Practice Address - Country:US
Practice Address - Phone:540-563-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001245996163W00000X
VA0024178402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse