Provider Demographics
NPI:1629883236
Name:HAMILTON, AIESHA MARY LEE
Entity type:Individual
Prefix:
First Name:AIESHA
Middle Name:MARY LEE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 W FUNDERBURG RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-2344
Mailing Address - Country:US
Mailing Address - Phone:937-503-5720
Mailing Address - Fax:
Practice Address - Street 1:625 W FUNDERBURG RD
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-2344
Practice Address - Country:US
Practice Address - Phone:937-503-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant