Provider Demographics
NPI:1659509792
Name:HAMILTON, MELISSA S (APRN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:S
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 THOMAS RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7365
Mailing Address - Country:US
Mailing Address - Phone:318-329-8485
Mailing Address - Fax:318-329-8483
Practice Address - Street 1:102 THOMAS RD STE 104
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7365
Practice Address - Country:US
Practice Address - Phone:318-329-8485
Practice Address - Fax:318-329-8483
Is Sole Proprietor?:No
Enumeration Date:2009-06-28
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAP05819OtherAPRN LA NUMBER