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Individual

MS. DEBORAH LEIGH HAWKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
4605 MACCORKLE AVE SW, CHARLESTON, WV 25309-1311
(304) 344-0096
Mailing address
1914 CLARK POINT TER, CHARLESTON, WV 25314-9748
(304) 546-9662
(304) 768-2468

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
50592
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
70067
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2603881000
WV
01
27-3419445
TAX ID
WV
01
P00082314
R MEDICA
WV
Enumeration date
09/21/2006
Last updated
07/21/2022
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