Provider Demographics
NPI:1689337693
Name:HAMILTON, VALARIA C (RN, BSN, CCM, DOULA)
Entity Type:Individual
Prefix:MRS
First Name:VALARIA
Middle Name:C
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RN, BSN, CCM, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 N MAIN ST UNIT 792
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-7733
Mailing Address - Country:US
Mailing Address - Phone:352-660-9714
Mailing Address - Fax:
Practice Address - Street 1:25101 SW 9TH LN
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-0049
Practice Address - Country:US
Practice Address - Phone:352-660-9714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-17
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9439288174H00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9439288OtherRN LICENSE