Provider Demographics
NPI:1801975248
Name:HAMILTON, TAMMY GROVE (DNP,BC)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:GROVE
Last Name:HAMILTON
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Gender:F
Credentials:DNP,BC
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Mailing Address - Street 1:1000 TAVERN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-2864
Mailing Address - Country:US
Mailing Address - Phone:304-267-9355
Mailing Address - Fax:304-267-9358
Practice Address - Street 1:1000 TAVERN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-2864
Practice Address - Country:US
Practice Address - Phone:304-267-9355
Practice Address - Fax:304-267-9358
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2014-01-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV33330363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily