Individual
NICOLE HAWKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2310 E BROWN RD, MESA, AZ 85213-5226
(480) 649-9000
(480) 248-9213
Mailing address
2310 E BROWN RD, MESA, AZ 85213-5226
(480) 649-9000
(480) 243-9213
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3274
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3274
STATE LICENSE
AZ
Enumeration date
05/03/2007
Last updated
11/17/2015
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