Provider Demographics
NPI:1457658593
Name:HAMRICK, CHELLYN WILLIAMSON (FNP)
Entity Type:Individual
Prefix:
First Name:CHELLYN
Middle Name:WILLIAMSON
Last Name:HAMRICK
Suffix:
Gender:F
Credentials:FNP
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 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:447 MCALISTER RD
Practice Address - Street 2:STE 2400
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4114
Practice Address - Country:US
Practice Address - Phone:980-212-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-25
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005083363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1457658593Medicaid
NC7005225Medicaid
SCNP3420Medicaid
NCNC2964GMedicare PIN
NCNC2964LMedicare PIN
NCNC2964NMedicare PIN
NCNC2964PMedicare PIN
NCNC2964DMedicare PIN
NC7005225Medicaid
NC1457658593Medicaid
NCNC2964IMedicare PIN
NCNC2964JMedicare PIN
NCNC2964MMedicare PIN
NCNC2964BMedicare PIN
NCNC2964HMedicare PIN
NCNC2964OMedicare PIN
NCNC2964EMedicare PIN
NCNC2964KMedicare PIN