Provider Demographics
NPI:1528424306
Name:HAMILTON, CHRISTINA LOUISE (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LOUISE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:APRN
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 179
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462-0179
Mailing Address - Country:US
Mailing Address - Phone:918-790-2653
Mailing Address - Fax:918-790-2657
Practice Address - Street 1:1630 S KERR BLVD
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-7240
Practice Address - Country:US
Practice Address - Phone:918-790-2653
Practice Address - Fax:918-790-2657
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK119560363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner