Provider Demographics
NPI:1669671996
Name:HAMILTON, LAURIE HARVEY (RN)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:HARVEY
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 HUDSON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5038
Mailing Address - Country:US
Mailing Address - Phone:770-507-1234
Mailing Address - Fax:770-507-1011
Practice Address - Street 1:1920 HUDSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5038
Practice Address - Country:US
Practice Address - Phone:770-507-1234
Practice Address - Fax:770-507-1011
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN143309163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse