Provider Demographics
NPI:1669827952
Name:HAMLETT, ANTHONY GLENN (FNP-BC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:GLENN
Last Name:HAMLETT
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 BEVERLY HILLS CIR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5241
Mailing Address - Country:US
Mailing Address - Phone:434-941-1943
Mailing Address - Fax:
Practice Address - Street 1:241 BEVERLY HILLS CIR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5241
Practice Address - Country:US
Practice Address - Phone:434-941-1943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173323363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily