Individual
ANITA HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
971 SALISBURY RIDGE RD, WINSTON SALEM, NC 27127-3709
(800) 380-1947
(336) 777-0624
Mailing address
971 SALISBURY RIDGE RD, WINSTON SALEM, NC 27127-3709
(800) 380-1947
(336) 777-0624
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
1565
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0720R
BCBS
NC
05
—
3406883
—
NC
01
—
43558
PARTNERS MEDICARE
NC
Enumeration date
06/18/2006
Last updated
10/18/2007
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