Provider Demographics
NPI:1851340079
Name:HAMRICK, BARBARA S (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:S
Last Name:HAMRICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3630
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86003-3630
Mailing Address - Country:US
Mailing Address - Phone:928-213-6100
Mailing Address - Fax:928-774-6687
Practice Address - Street 1:2650 E SHOW LOW LAKE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-7955
Practice Address - Country:US
Practice Address - Phone:928-537-4300
Practice Address - Fax:928-537-4301
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN031400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ432266Medicaid
AZ432266Medicaid