Shaunda L Hamilton
Individual provider Active NPI Contractor · Columbia, MO
NPI 1770053449 · NPPES record last updated Nov 26, 2018
Key facts
- NPI
- 1770053449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 3109 Jenne Hill Dr
Columbia, MO 65202-4060 - Phone
- (573) 268-2797
- NPI assigned
- Nov 26, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
3109 Jenne Hill Dr
Columbia, MO 65202-4060
Mailing address
3109 Jenne Hill Dr
Columbia, MO 65202-4060
Phone (573) 268-2797
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.