Provider Demographics
NPI:1932472354
Name:HAMILTON, CHRISTY M (CRNA)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:M
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5500 MARKET ST
Mailing Address - Street 2:SUITE 119
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2601
Mailing Address - Country:US
Mailing Address - Phone:724-824-4096
Mailing Address - Fax:724-269-9476
Practice Address - Street 1:1211 WILMINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-2516
Practice Address - Country:US
Practice Address - Phone:724-824-4096
Practice Address - Fax:724-269-9476
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN562414163W00000X
PA088428367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse