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Individual

MR. DALE WADE HAWKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N.P.

Contact information

Practice address
5840 N LA CHOLLA BLVD, TUCSON, AZ 85741-3537
(520) 519-8560
Mailing address
1477 W COMMERCE CT, TUCSON, AZ 85746-6016
(520) 792-3293
(520) 792-4336

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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