Individual
MS. CANDICE R HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 UNIVERSITY BLVD, UH 3005, INDIANAPOLIS, IN 46202-5149
(317) 944-2167
(317) 944-2305
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001487A
IN
363LP2300X
Primary Care Nurse Practitioner
71001487A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000612784
ANTHEM
—
05
—
200939930
—
IN
Enumeration date
10/03/2006
Last updated
02/04/2014
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