Individual
JEANNETTE KWANT HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
629200
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1768236001
—
TX
05
—
176823601
—
TX
01
—
85440U
BCBS
TX
01
—
P00428301
RAILROAD
TX
Enumeration date
12/28/2005
Last updated
06/23/2020
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