Provider Demographics
NPI:1922087048
Name:HAMILTON, REBECCA (RN-FNP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RN-FNP
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:STREETY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN-FNP
Mailing Address - Street 1:501 MIDWESTERN PKWY E
Mailing Address - Street 2:ATTN: PATTI SEARLES
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76302-2302
Mailing Address - Country:US
Mailing Address - Phone:940-766-8435
Mailing Address - Fax:940-766-8497
Practice Address - Street 1:501 MIDWESTERN PKWY E
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-2302
Practice Address - Country:US
Practice Address - Phone:940-766-3551
Practice Address - Fax:940-766-8420
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253172363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR59528Medicare UPIN