NPI | 1972025674 |
---|---|
Former Name | REGINA DEINSE HAWKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F308511) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F308511) |
363LP2300X Nurse Practitioner, Primary Care (Licence: AL AG02170125) | |
Enumeration Date | 2017-07-13 |
Last Update Date | 2020-01-21 |