Individual
MARANDA HAWKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
363 S FIELDSTONE BLVD, BLOOMINGTON, IN 47403-9809
(812) 825-0551
Mailing address
363 S FIELDSTONE BLVD, BLOOMINGTON, IN 47403-9809
(812) 825-0551
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
28191860A
IN
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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