WILLIE HAMILTON (NPI# 1164433587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164433587 |
| Entity Type | Individual |
| Full Name | WILLIE HAMILTON |
| Credential | FNP |
| Practice Address |
110 W Main St Suite 2 Lebanon VA 24266-4560 |
| Mailing Address |
1901 Brookside Dr Suite 105 Kingsport TN 37660-4617 |
| Practice Telephone | 2768800136 |
| Practice Fax Number | 2768800164 |
| Mailing Telephone | 4237659500 |
| Mailing Fax Number | 4237659503 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2014-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | RN00115147 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024170002 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
7613 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 007794851 | 05 |
| Street Address |
110 W MAIN ST SUITE 2 |
| City | LEBANON |
| State | VA |
| Zip Code | 24266-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477534709 | Street Drug Corporation | Pharmacy | 110 W Main St, Lebanon, VA 24266-4214 | 2005-11-14 |
| 1659703734 | Gloria Faye Kennedy | Nurse Practitioner | 110 W Main St, Suite 2, Lebanon, VA 24266-4214 | 2013-07-31 |
| 1184935215 | Choice Respiratory & Medical Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 110 W Main St, Suite 3a, Lebanon, VA 24266 | 2010-06-23 |
| 1982745741 | Pulmonary Associates of Kingsport | Clinic/Center | 110 W Main St, Suite 3, Lebanon, VA 24266-4214 | 2007-02-12 |
| 1164407177 | Ralph Lee Street | Pharmacist | 110 W Main St, Suite #1, Lebanon, VA 24266-4430 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541174 | Nextdoor Drug | Pharmacist | 932 W Main St, Lebanon, VA 24266 | 2020-06-04 |
| 1720638661 | Advanced Practice Primary Care, Pllc | Nurse Practitioner | 2336 Coal Tipple Hollow, Lebanon, VA 24266 | 2019-09-12 |
| 1962051763 | Best Life Physical Therapy Inc. | Physical Therapist | 383 Technology Park Drive, Lebanon, VA 24266 | 2019-09-05 |
| 1093361024 | Alexis Rae Carson | Psychologist | 84 Dr Lorraine C. Turner Dr. Russell County Public Scho, Lebanon, VA 24266 | 2019-08-15 |
| 1457821019 | Blue Ridge Medical Management Corporation | Internal Medicine | 71 S Flannagan Ave Suite 81, Lebanon, VA 24266 | 2018-11-27 |
| 1457867202 | Elizabeth Altizer Baker | Speech-Language Pathologist | 84 Lorraine C. Turner Dr., Russell County Public Schools, Lebanon, VA 24266 | 2017-12-15 |
| 1851805683 | Laura Hankins Vencill | Speech-Language Pathologist | Russell County Public Schools, 84 Lorraine C. Turner Dr., Lebanon, VA 24266 | 2017-12-01 |
| 1487168670 | Stacy Nichole Davis | Counselor | 78 Rogers St, Lebanon, VA 24266 | 2017-11-27 |
| 1568976751 | Kelly Elizabeth Smith | Counselor | 216 Gilmer Street, Lebanon, VA 24266 | 2017-11-27 |
| 1659883312 | Sara K Poole | Occupational Therapist | 408 Fields Ave., Lebanon, VA 24266 | 2017-11-02 |
| Find all providers in zip 24266 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912170 | Kaley Elizabeth Barrett | Nurse Practitioner | 418 Edgewood Dr, Lebanon, PA 17042-9109 | 2020-11-04 |
| 1932716420 | Jessica Erb | Nurse Practitioner | 804 Holly Ln, Lebanon, PA 17042-9028 | 2020-09-28 |
| 1922619527 | Tammy Lynn Whitt | Nurse Practitioner | 961 Poor Farm Rd, Lebanon, VA 24266-7097 | 2020-08-17 |
| 1538777529 | Shenia Diane Johnson | Nurse Practitioner | 71 S. Flannagan Ave., Lebanon, VA 24266-2426 | 2020-07-16 |
| 1275158164 | Kelly Mcdaniel | Nurse Practitioner | 288 Rolling Meadows Rd, Lebanon, VA 24266-5870 | 2020-06-16 |
| 1609498955 | Kelsey Jones | Nurse Practitioner | 1412 Nathaniel Dr, Lebanon, MO 65536-8906 | 2020-05-09 |
| 1124657887 | Shelly Prather | Nurse Practitioner | 350 Wheeler St, Lebanon, OR 97355-4349 | 2020-04-05 |
| 1205479458 | Natasha Denney Arentz | Nurse Practitioner | 5787 Oh-63, Lebanon, OH 45036 | 2019-10-21 |
| 1720638661 | Advanced Practice Primary Care, Pllc | Nurse Practitioner | 2336 Coal Tipple Hollow, Lebanon, VA 24266 | 2019-09-12 |
| 1821642430 | Jill Montgomery Major | Nurse Practitioner | 135 Knights Brg, Lebanon, TN 37090-1410 | 2019-07-31 |
| Find all providers in LEBANON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.