Provider Demographics
NPI:1295872737
Name:HAMRICK, DAVID JOE (CRNA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOE
Last Name:HAMRICK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 DRIFTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-3424
Mailing Address - Country:US
Mailing Address - Phone:850-248-4045
Mailing Address - Fax:
Practice Address - Street 1:712 DRIFTWOOD DR
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-3424
Practice Address - Country:US
Practice Address - Phone:850-248-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1122182367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered