Provider Demographics
NPI:1063955540
Name:HAMILTON, JOHANNA MARIE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JOHANNA
Middle Name:MARIE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:JOHANNA
Other - Middle Name:MARIE
Other - Last Name:MCANALLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9195 GRANT ST STE 301
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4386
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9195 GRANT ST STE 301
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4386
Practice Address - Country:US
Practice Address - Phone:720-678-9828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0999134-NP363LA2200X
AL1-140359363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health