Provider Demographics
NPI:1255040432
Name:HAMILTON, REBECCA JULIET (FNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JULIET
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 HIDDEN VALLEY DR APT 6304
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1475
Mailing Address - Country:US
Mailing Address - Phone:949-554-4738
Mailing Address - Fax:
Practice Address - Street 1:12731 RESEARCH BLVD STE B200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4387
Practice Address - Country:US
Practice Address - Phone:949-554-4738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1021690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty