Provider Demographics
NPI:1366264137
Name:HAMILTON, CARL (CRNP)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7678 QUARTERFIELD RD STE 201
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-7071
Mailing Address - Country:US
Mailing Address - Phone:410-766-9413
Mailing Address - Fax:410-768-1750
Practice Address - Street 1:7678 QUARTERFIELD RD STE 201
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-7071
Practice Address - Country:US
Practice Address - Phone:410-766-9413
Practice Address - Fax:410-768-1750
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR230434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily