Provider Demographics
NPI:1821009978
Name:HAMILTON, SHARILYN ANN (CNP)
Entity Type:Individual
Prefix:
First Name:SHARILYN
Middle Name:ANN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SHARILYN
Other - Middle Name:ANN
Other - Last Name:ELDRIDGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6438 WILMINGTON PIKE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-7022
Mailing Address - Country:US
Mailing Address - Phone:937-433-5309
Mailing Address - Fax:937-424-3650
Practice Address - Street 1:6438 WILMINGTON PIKE
Practice Address - Street 2:SUITE 220
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-7022
Practice Address - Country:US
Practice Address - Phone:937-433-5309
Practice Address - Fax:937-424-3650
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA-08777-NP363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHANP20541OtherMEDICARE RAILROAD
OH2669303Medicaid
OHQ67192Medicare UPIN
OH2669303Medicaid