Doctor Name: | CARLIE JO HAMILTON |
NPI Number: | 1104978873 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 294110-4405 |
Business Practice Address: | 12272 S 800 E Suite A Draper, UT - 840209789 |
Business Phone Number: | 8015231300 |
Business Fax Number: | 8015231301 |
Mailing Address: | 12272 S 800 E, Suite A DRAPER |
State: | UT |
Postal Code: | 840209789 |
Phone Number: | 8015231300 |
Fax Number: | 8015231301 |
NPI Enumeration Date: | 01/16/2007 |
NPI Last Update Date: | 08/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 294110-4405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |