Individual
STACEY HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,GNP
Contact information
Practice address
1108 LAVACA ST, SUITE 110-320, AUSTIN, TX 78701-2172
(512) 477-4088
(512) 482-0390
Mailing address
1108 LAVACA ST, SUITE 110-320, AUSTIN, TX 78701-2172
(512) 477-4088
(512) 482-0390
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
512782
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044330102
—
TX
01
—
500028186
MEDICARE RAILROAD
TX
01
—
84P274
BCBS TEXAS
TX
Enumeration date
07/26/2006
Last updated
05/24/2011
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