Provider Demographics
NPI:1063025054
Name:HAMILTON, JESSICA KATE (APRN)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:KATE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:303 N CLYDE MORRIS BLVD
Mailing Address - Street 2:10E PBFS
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2709
Mailing Address - Country:US
Mailing Address - Phone:386-425-7359
Mailing Address - Fax:386-425-4481
Practice Address - Street 1:775 W GRANADA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5109
Practice Address - Country:US
Practice Address - Phone:386-425-4480
Practice Address - Fax:386-425-4481
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008904363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily