Provider Demographics
NPI:1598297350
Name:HAMLIN, ALLISON ROSE (FNP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:ROSE
Last Name:HAMLIN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:ROSE
Other - Last Name:ALDRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12433 SILVERTON RD NE
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-9365
Mailing Address - Country:US
Mailing Address - Phone:503-569-2663
Mailing Address - Fax:
Practice Address - Street 1:12433 SILVERTON RD NE
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-9365
Practice Address - Country:US
Practice Address - Phone:503-569-2663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201702241NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily