Provider Demographics
NPI:1700577319
Name:HAMILTON, CHLOE NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:NICOLE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 SUMMIT CROSSING PL STE 108A
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2189
Mailing Address - Country:US
Mailing Address - Phone:704-865-2229
Mailing Address - Fax:
Practice Address - Street 1:620 SUMMIT CROSSING PL STE 108A
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2189
Practice Address - Country:US
Practice Address - Phone:704-865-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-13971207V00000X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology