Provider Demographics
NPI:1598181315
Name:HAMILTON, AVIS JOLEEN (CRNP)
Entity Type:Individual
Prefix:
First Name:AVIS
Middle Name:JOLEEN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:AVIS
Other - Middle Name:JOLEEN
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP-FNP
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0116
Mailing Address - Country:US
Mailing Address - Phone:256-533-7064
Mailing Address - Fax:256-704-0115
Practice Address - Street 1:201 GOVERNORS DR SW STE 400
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5183
Practice Address - Country:US
Practice Address - Phone:256-265-7246
Practice Address - Fax:256-265-7017
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-114219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily