Provider Demographics
NPI:1366114191
Name:HAMILTON, SHIRLEY A (RN)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:A
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 WOOSTER RD APT 609
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-4153
Mailing Address - Country:US
Mailing Address - Phone:440-213-9409
Mailing Address - Fax:
Practice Address - Street 1:3420 WOOSTER RD APT 609
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-4153
Practice Address - Country:US
Practice Address - Phone:440-213-9409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.105757163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse