Provider Demographics
NPI:1396026910
Name:HAMILTON, KRISTEN KRUSE (AUD)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:KRUSE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:KRUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1308 MIDDLESEX DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4242
Mailing Address - Country:US
Mailing Address - Phone:817-751-8215
Mailing Address - Fax:
Practice Address - Street 1:33917 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2628
Practice Address - Country:US
Practice Address - Phone:727-771-8770
Practice Address - Fax:727-771-8771
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80298231H00000X, 231H00000X
FLAY2646231H00000X
237600000X, 231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX530294OtherBCBS