Individual
MRS. ODESSA ANN HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
950 N MARKET ST, LIBERTY, IN 47353-8496
(765) 458-5191
(765) 458-7301
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 983-3127
(765) 983-3219
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28170007A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000736285
ANTHEM
—
05
—
201038750
—
IN
Enumeration date
08/12/2011
Last updated
12/23/2013
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