Provider Demographics
NPI:1912252990
Name:HAMILTON, SHIRLEY K (RN)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:K
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:MINFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45653-8530
Mailing Address - Country:US
Mailing Address - Phone:740-464-5495
Mailing Address - Fax:
Practice Address - Street 1:48 HAYES ST
Practice Address - Street 2:
Practice Address - City:MINFORD
Practice Address - State:OH
Practice Address - Zip Code:45653-8530
Practice Address - Country:US
Practice Address - Phone:740-464-5495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN149042-M-IV164W00000X
OHRN.421273-163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse