1811185911 NPI number — MRS. ERICA DON HAMILTON CRNA

Table of content: DONNA MCDONALD PHD (NPI 1346020096)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811185911 NPI number — MRS. ERICA DON HAMILTON CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMILTON
Provider First Name:
ERICA
Provider Middle Name:
DON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LUCCI
Provider Other First Name:
ERICA
Provider Other Middle Name:
DON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1811185911
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3100 SPRING FOREST RD STE 130
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27616-2880
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-882-0795
Provider Business Mailing Address Fax Number:
919-873-9821

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 KILDAIRE FARM RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27518-6616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-350-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  63041 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: 77851 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9333201 . This is a "MEDICARE GROUP" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 3810010544 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0207026000 . This is a "MEDICAID GROUP" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".