Provider Demographics
NPI:1699873612
Name:HAMILTON, JOJEAN (NP)
Entity type:Individual
Prefix:MS
First Name:JOJEAN
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 ELECTRIC AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-6588
Mailing Address - Country:US
Mailing Address - Phone:810-329-3333
Mailing Address - Fax:810-329-1199
Practice Address - Street 1:2603 ELECTRIC AVE STE 2
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-6588
Practice Address - Country:US
Practice Address - Phone:810-329-3333
Practice Address - Fax:810-329-1199
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704159448176B00000X, 363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No176B00000XOther Service ProvidersMidwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI500G40990OtherBCBS GROUP
MI1699873612OtherNPI
MI4704159448OtherSTATE LICENSE
MI4704159448OtherSTATE LICENSE