Provider Demographics
NPI:1336396258
Name:HAMILTON, KRISTIN M (MSPA,PA-C)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:M
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MSPA,PA-C
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Other - First Name:
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Mailing Address - Street 1:3061 S MARYLAND PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-6227
Mailing Address - Country:US
Mailing Address - Phone:702-737-1948
Mailing Address - Fax:702-737-7195
Practice Address - Street 1:3061 S MARYLAND PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-6227
Practice Address - Country:US
Practice Address - Phone:702-737-1948
Practice Address - Fax:702-737-7195
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVPA1015363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ429682Medicaid
NVA0742YOtherPALMETTO MEDICARE J1
NV1336396258Medicaid