Provider Demographics
NPI:1568892842
Name:HAMILTON, TOMMIE JUNE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TOMMIE
Middle Name:JUNE
Last Name:HAMILTON
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 1:960 STATE ROUTE 212
Mailing Address - Street 2:
Mailing Address - City:TIPTONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38079-4037
Mailing Address - Country:US
Mailing Address - Phone:731-253-5000
Mailing Address - Fax:
Practice Address - Street 1:4092 SIMRELL RD
Practice Address - Street 2:
Practice Address - City:OBION
Practice Address - State:TN
Practice Address - Zip Code:38240-4614
Practice Address - Country:US
Practice Address - Phone:731-253-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18135363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily