Provider Demographics
NPI:1346895588
Name:HAMILL, MEREDITH LILLIAN (MS, ATC, NRP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LILLIAN
Last Name:HAMILL
Suffix:
Gender:F
Credentials:MS, ATC, NRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 ALDEN RD
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-4009
Mailing Address - Country:US
Mailing Address - Phone:336-263-5693
Mailing Address - Fax:
Practice Address - Street 1:1000 REMINGTON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-1118
Practice Address - Country:US
Practice Address - Phone:570-207-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
PA212383146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer