Provider Demographics
NPI:1336310960
Name:HAMIL, TAYLOR ANN (LM, CPM, LMT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:HAMIL
Suffix:
Gender:F
Credentials:LM, CPM, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3645
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-3645
Mailing Address - Country:US
Mailing Address - Phone:206-861-5009
Mailing Address - Fax:
Practice Address - Street 1:74-5577 PALANI RD UNIT 3645
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96745-7166
Practice Address - Country:US
Practice Address - Phone:206-861-5009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM315176B00000X
WAMW60262585176B00000X
WAMA00019760225700000X
HIMW17175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay
No176B00000XOther Service ProvidersMidwife
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist