Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 4704361721 | MI |
NPI | 1023687621 |
---|---|
Provider Name | Kaylyn Hamilton |
First Address | Perrysburg, OH 43551-9033 |
Second Address | Dearborn, MI 48124-4089 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2021 |
Last Update Date | 18/06/2021 |