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Individual
MR. DALE WADE HAWKINS
Active
Individual
MR. DALE WADE HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
4704165653
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP3146
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366792
—
AZ
05
—
4670866
—
MI
Enumeration date
01/10/2007
Last updated
08/03/2021
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