Individual
CLAYTON HAWKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642-6351
(208) 706-5930
Mailing address
3709 W MORRIS HILL RD, BOISE, ID 83706-2643
(208) 869-5105
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-63794
ID
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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