Individual
MS. JILLISA D HAWK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
305 ESTILL ST, BEREA, KY 40403-1742
(859) 986-9521
(859) 986-7369
Mailing address
PO BOX 484, BEREA, KY 40403-0484
(859) 986-9521
(859) 986-7369
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5652P
KY
Other
Enumeration date
08/15/2008
Last updated
08/15/2008
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