Provider Demographics
NPI:1730987959
Name:HAMILTON, KARLIE LYNN (MSN, RN)
Entity type:Individual
Prefix:
First Name:KARLIE
Middle Name:LYNN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:KARLIE
Other - Middle Name:LYNN
Other - Last Name:LADING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN
Mailing Address - Street 1:322 FAIRWOOD HILLS RD
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-3560
Mailing Address - Country:US
Mailing Address - Phone:217-259-4000
Mailing Address - Fax:
Practice Address - Street 1:1 HAIRPIN DR
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62026-0001
Practice Address - Country:US
Practice Address - Phone:618-650-3705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019022630163W00000X
IL041525335163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse