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Individual

ETHAN HAMILTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
621 W LAKE ST STE 350, MINNEAPOLIS, MN 55408-2952
(612) 979-2276
Mailing address
428 MINNESOTA ST UNIT 500, SAINT PAUL, MN 55101-2666

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2470803
MN
163WP0808X
Psychiatric/Mental Health Registered Nurse
1640188
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6446
MN

Other

Enumeration date
05/24/2018
Last updated
10/22/2025
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