Provider Demographics
NPI:1063878544
Name:HAMILTON, JENNIFER (BHS)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:BHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6324
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49204-6324
Mailing Address - Country:US
Mailing Address - Phone:517-435-9842
Mailing Address - Fax:
Practice Address - Street 1:1009 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-4120
Practice Address - Country:US
Practice Address - Phone:517-435-9842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator