Provider Demographics
NPI:1851390249
Name:HAMILTON, CONSTANCE ANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:ANNE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:CONSTANCE
Other - Middle Name:ANNE
Other - Last Name:BORGFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:428 MARTIN RD
Mailing Address - Street 2:MARTIN WOODS
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-5524
Mailing Address - Country:US
Mailing Address - Phone:912-369-5366
Mailing Address - Fax:
Practice Address - Street 1:421 HARMON AVE
Practice Address - Street 2:SUITE 2J11B
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5611
Practice Address - Country:US
Practice Address - Phone:912-435-0625
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA096598163WP0200X
KY1051142163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics