Provider Demographics
NPI:1053334326
Name:HAMILTON, MARY T (CNM)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:T
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:T
Other - Last Name:MCNAIRNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:140 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3102
Mailing Address - Country:US
Mailing Address - Phone:207-768-5944
Mailing Address - Fax:207-768-3203
Practice Address - Street 1:140 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3102
Practice Address - Country:US
Practice Address - Phone:207-768-5944
Practice Address - Fax:207-768-3203
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNM82040367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1053334326Medicaid
ME1053334326Medicaid