Provider Demographics
NPI:1821139833
Name:HAMILTON, LADY LOUGHRY (APN)
Entity Type:Individual
Prefix:MRS
First Name:LADY
Middle Name:LOUGHRY
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 BRADBERRY DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-1146
Mailing Address - Country:US
Mailing Address - Phone:615-893-4770
Mailing Address - Fax:
Practice Address - Street 1:1500 GREENLAND DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37132-3100
Practice Address - Country:US
Practice Address - Phone:615-898-2988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12493363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health