Individual
PROF. MICHELLE JUANITA HAWTHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 EHRBAR AVE APT 3A, MOUNT VERNON, NY 10552-3671
(917) 504-5683
Mailing address
25 EHRBAR AVE APT 3A, MOUNT VERNON, NY 10552-3671
(917) 504-5683
Taxonomy
Speciality
Code
Description
License number
State
163WD1100X
Peritoneal Dialysis Registered Nurse
Primary
916160
NY
Other
Enumeration date
10/20/2025
Last updated
10/24/2025
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