Provider Demographics
NPI:1912550633
Name:HAMILTON, KRISTEN ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9317 HUNTING VALLEY RD S
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1554
Mailing Address - Country:US
Mailing Address - Phone:716-545-5563
Mailing Address - Fax:
Practice Address - Street 1:9317 HUNTING VALLEY RD S
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-1554
Practice Address - Country:US
Practice Address - Phone:716-545-5563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant