Provider Demographics
NPI:1487766978
Name:HAMILL, TERESA JEANNE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:JEANNE
Last Name:HAMILL
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:305 WHITE DR
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-2638
Mailing Address - Country:US
Mailing Address - Phone:662-324-7941
Mailing Address - Fax:
Practice Address - Street 1:1100 COLLEGE ST
Practice Address - Street 2:MUW-330
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39701-5800
Practice Address - Country:US
Practice Address - Phone:662-329-7289
Practice Address - Fax:662-241-7486
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR654302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily