Provider Demographics
NPI:1710452750
Name:HAMILTON, CYNTHIA (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:HARDIN HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7353 SISTERS GRV
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-2615
Mailing Address - Country:US
Mailing Address - Phone:719-444-8484
Mailing Address - Fax:
Practice Address - Street 1:6160 TUTT BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-3503
Practice Address - Country:US
Practice Address - Phone:719-473-2346
Practice Address - Fax:719-577-9627
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN00994206363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAPN00994206OtherSTATE LICENSE