Provider Demographics
NPI:1114206174
Name:HAMILTON, KIMBERLY M (FNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:M
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1028 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1328
Mailing Address - Country:US
Mailing Address - Phone:606-783-6400
Mailing Address - Fax:606-783-6415
Practice Address - Street 1:1028 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-1328
Practice Address - Country:US
Practice Address - Phone:606-783-6400
Practice Address - Fax:606-783-6415
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007077363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100196680Medicaid
KYK014306Medicare PIN