Provider Demographics
NPI:1144422528
Name:HAWKINS, TRINA H (GNP)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:H
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 PEACHTREE ST NW STE 1010
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2497
Mailing Address - Country:US
Mailing Address - Phone:678-394-3613
Mailing Address - Fax:
Practice Address - Street 1:2465 MAIN ST UNIT 110
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-2675
Practice Address - Country:US
Practice Address - Phone:678-394-3613
Practice Address - Fax:404-341-9369
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX690022363LG0600X
TXAP115236363LG0600X
GARN281869363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185943103Medicaid
TX185943104OtherCSHCN
TX8Y2037OtherBCBS
TX185943101Medicaid
TXP00450454Medicare PIN
TX185943101Medicaid
TX8J6906Medicare PIN