Provider Demographics
NPI:1477194140
Name:HAMELRATH, MONIQUE MCCLEERY (FNP-C)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:MCCLEERY
Last Name:HAMELRATH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:L
Other - Last Name:MCCLEERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:66 WAHCONAH STREET
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201
Mailing Address - Country:US
Mailing Address - Phone:413-496-6870
Mailing Address - Fax:413-496-6872
Practice Address - Street 1:66 WAHCONAH STREET
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-496-6870
Practice Address - Fax:413-496-6872
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207919363LF0000X
MAMM6169622363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily